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Diagnoses and decisions that we encounter nearly every day as nephrologists are often life-changing for patients. Sometimes, when more than one potential course of action exists, we must give our patients grace and time, allowing them agency in coming to a medically safe shared decision.
The success of the kidney transplantation programme in Nepal offers lessons in persistence, collaboration and policy reform. In low-resource settings, access to transplantation remains limited, but locally led efforts — supported by training and political will — can shift the landscape and make equitable transplant care possible.
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.
In early 2025, nearly 2,100 research projects funded by the US National Institutes of Health (NIH) were terminated. Numerous calls for depoliticization of the NIH’s scientific mission culminated in the Bethesda declaration, which has now been signed by over 32,000 individuals. However, little attention has been given to the effect of these terminations on people who stand to benefit most from scientific discoveries: the patients, care partners and community leaders.
A global shortage of suitable donor kidneys is the primary challenge in kidney transplantation. In this Review, the authors describe different methods of donor kidney preservation, discussing the strengths and limitations of each method and noting how advances in donor organ perfusion could improve organ utilization and patient outcomes.
Here, the authors describe the effects of coronavirus disease (COVID) on the kidney, including long COVID in patients with chronic kidney disease. They also discuss potential associations between COVID-19 and glomerular diseases and the impact of severe acute respiratory syndrome coronavirus 2 vaccines on the risk of long COVID.
Here, the authors summarize current evidence and guidance for physical activity in chronic kidney disease. They outline barriers and facilitators to the implementation of physical activity and exercise programmes in chronic kidney disease clinical practice and suggest approaches to facilitating translation of research findings into routine care.
An economic evaluation can provide insights into the cost-effectiveness of different kidney replacement therapy modalities to inform decisions on how to best allocate limited resources. This evidence-based Guideline is aimed at equipping policymakers and medical personnel with insight into the principles of economic evaluation within the context of policies for kidney-failure services, and increasing their confidence in requesting and using economic evidence derived from such evaluations.
