Articles in 2025

Kidneys are highly susceptible to acute injury. Several studies in 2025 revealed insights into mechanisms of protection and susceptibility — including sex-specific mechanisms of protection against ferroptosis, mechanisms of impaired resilience imparted by mitochondrial DNA mutations, and a role for tRNA-Asp-GTC-3′tDR in RNA autophagy — that provide new directions for diagnostic tools and therapies for acute kidney injury.

Cardiovascular–kidney–metabolic (CKM) syndrome reflects the intricate connections between metabolic disorders, chronic kidney disease and cardiovascular disease. In 2025, key studies advanced understanding of risk prediction in CKM syndrome, including the role of social determinants of health, as well as combination treatment strategies and potential therapeutic targets to improve CKM health.

In this Tools of the Trade article, Nicholas Lucarelli (Computational Microscopy Imaging Lab, directed by Pinaki Sarder) describes the development of FUSION, a cloud-based platform for the integration of histology and spatial -omics data.

Although 2025 began with disruption and geopolitical retreat, momentum in kidney health advocacy endured. Global, regional and national efforts demonstrated that progress is possible when commitment persists and setbacks are recognized, offering opportunities to lessen the burden of kidney disease and improve access to equitable and sustainable kidney care.

New studies in autoimmune kidney disease demonstrate the complex interplay between immune and non-immune cells that underlies kidney inflammation and fibrosis. Differences between these autoimmune responses and those observed in kidney allograft rejection, as well as insights from clinical responses to immunotherapy, provide further clues on key pathways driving kidney inflammation.

In 2025, several landmark studies illuminated the sequence of immune events that influence tolerance and rejection in kidney transplantation, from the molecular triggers of allorecognition to the chemotactic control of cytotoxicity and the protective mechanisms underlying the benefits of immune therapies. As xenotransplantation advances, these insights will also be important for achieving sustained xenograft tolerance.

Here, the authors provide guidance on the prevention, diagnosis and management of anticancer therapy nephrotoxicity in adult patients. They also define a research agenda focused on preventing and mitigating anticancer therapy toxicity, maximizing early detection of nephrotoxicity and enabling optimal drug dosing in patients with kidney disease.

Here, the authors describe the spectrum and global burden of AKI. They discuss the knowledge and practice gaps that must be addressed to improve AKI care and outline a framework for creating a sustainable infrastructure to address this global health issue.

This Review discusses the latest advances in natural killer cell biology, including insights into population heterogeneity, and examines the roles of these innate lymphocytes in kidney health and disease, as well as their contribution to kidney allograft rejection and its therapeutic implications.

Effective kidney-targeted therapeutics require careful consideration of both the cargo and carrier. In the past year, considerable progress has been made in the development of viral and non-viral delivery vehicles, by leveraging endogenous biological mechanisms, screening across multiple species and administration routes, and artificial intelligence to drive kidney selectivity.

Cell–cell crosstalk is essential for the maintenance of organ and whole-body homeostasis. This Review summarizes current understanding of cell–cell crosstalk in the kidney in health and disease and describes how intercellular crosstalk shapes cell states and tissue organization to influence kidney homeostasis, injury responses and disease progression.

The glomerular endothelial glycocalyx lines the glomerular capillaries and contributes to the ability of these specialized blood vessels to limit protein permeability. This Review describes how dysfunction of the glomerular endothelial glycocalyx contributes to the development of proteinuria in glomerular disease and potential therapeutic approaches to protect or restore it.

Standard treatments to reduce cardiovascular risk, including mineralocorticoid receptor antagonists, have not lowered the high cardiovascular mortality and morbidity of patients on long-term haemodialysis. Future research should focus on targeting inflammatory pathways that are activated when blood interacts with dialysis membranes.

A new study reports that in 2010–2019, mortality owing to non-communicable diseases continued to decline in the majority of countries worldwide. However, the data also highlight major disparities between countries and a widespread slowing of progress in reducing mortality compared to the previous decade.

In this Tools of the Trade article, Liam McLaughlin (Jain lab) describes the development of an open-source Python tool that converts volumetric imaging data into quantifiable network graphs.

In this Tools of the Trade article, Fung and Shi describe a label-free optical imaging platform to capture the spatial molecular landscape of same-slide kidney tissue pathology.

In this Review, the authors outline the genetic causes and pathophysiology of monogenic syndromes associated with hypertension and discuss how common and rare variants contribute to hypertension at the population level.

As research on human kidney models differentiated directly from human pluripotent stem cells continues to advance rapidly, this Review examines current protocols used in the field, as well as discusses potential caveats and limitations when using these approaches for drug screening, disease modelling and tissue engineering.

Chronic kidney disease is a silent epidemic that is disproportionately affecting low- and middle-income countries. The landmark WHO global kidney health resolution signals urgency, but impact depends on action. Point-of-care diagnostics are essential to bridge the gap between recognition and reality, enabling equitable early detection, prevention and strengthening of health systems.

Implementation of the recently adopted World Health Organization resolution on kidney health will require not only additional funding, but also strategic investment. Embedding kidney health interventions into primary care and community-based non-communicable disease prevention and treatment platforms can rebalance resource allocation across the care continuum, improving both sustainability and fairness.