{"title":"Indigenous kidney health outcomes will not improve without multilevel interventions","authors":"","doi":"10.1038/s41581-025-01046-w","DOIUrl":"10.1038/s41581-025-01046-w","url":null,"abstract":"Kidney health data have long highlighted the disproportionate burden of kidney disease among Indigenous populations across the globe. It is time for meaningful interventions that can create real change.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 2","pages":"85-86"},"PeriodicalIF":39.8,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41581-025-01046-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146016505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strengthening kidney care through evidence-informed participatory policymaking","authors":"Neha Purohit, Shankar Prinja","doi":"10.1038/s41581-025-01032-2","DOIUrl":"10.1038/s41581-025-01032-2","url":null,"abstract":"Dialysis is among the most cost-intensive health services available; however, its availability is often shaped by competing interests among providers, payers, industry and patients. Thailand’s experience in aligning these interests offers valuable lessons for countries that are striving to expand equitable kidney care within limited fiscal space and progress towards universal health coverage.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 4","pages":"249-251"},"PeriodicalIF":39.8,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melissa R. Haswell, Javier Cortes-Ramirez, Louise G. Woodward
{"title":"Health risks of oil and gas development","authors":"Melissa R. Haswell, Javier Cortes-Ramirez, Louise G. Woodward","doi":"10.1038/s41581-026-01050-8","DOIUrl":"10.1038/s41581-026-01050-8","url":null,"abstract":"An increasing body of evidence has highlighted direct and indirect health implications of oil and gas expansion. Nations that produce oil, gas and petrochemicals must stop placing short-term interests above the health and future of humanity.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 3","pages":"169-170"},"PeriodicalIF":39.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Environmentally sustainable kidney care in low- and middle-income countries","authors":"Abdou Niang, Ahmed Tall Lemrabott","doi":"10.1038/s41581-026-01051-7","DOIUrl":"10.1038/s41581-026-01051-7","url":null,"abstract":"Low- and middle-income countries face a rapidly increasing prevalence of chronic kidney disease in a setting of limited resources and heightened environmental vulnerabilities. Disease prevention strategies, optimization of kidney replacement therapies, technological innovations and adaptation of health policies to local realities is required to enable resilient and sustainable kidney care.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 3","pages":"174-175"},"PeriodicalIF":39.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disentangling the role of environmental factors in the CKDu epidemic","authors":"Nicholas J. Osborne","doi":"10.1038/s41581-026-01054-4","DOIUrl":"10.1038/s41581-026-01054-4","url":null,"abstract":"Chronic kidney disease of unknown origin (CKDu) has been reported in various tropical settings over the past 20 years, but clarity on key disease drivers is lacking. Several factors have slowed progress in understanding this disease or diseases, including low research funding, difficult case definition and multiple risk factors for kidney disease.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 3","pages":"176-177"},"PeriodicalIF":39.8,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikolas E. J. Schmitz, Cristina Richie, Raghavendra Selvan, Loïc Lannelongue, Ariel Dora Stern, Nick Schneider, Joe Lennerz, Blanca Iciar Indave Ruiz, Martin Strauch, Peter Boor
{"title":"Sustainable AI in medicine: balancing benefits and environmental costs","authors":"Nikolas E. J. Schmitz, Cristina Richie, Raghavendra Selvan, Loïc Lannelongue, Ariel Dora Stern, Nick Schneider, Joe Lennerz, Blanca Iciar Indave Ruiz, Martin Strauch, Peter Boor","doi":"10.1038/s41581-026-01047-3","DOIUrl":"10.1038/s41581-026-01047-3","url":null,"abstract":"Artificial intelligence (AI) and deep learning could have a transformative effect on healthcare. However, this technology has a high carbon footprint, requires the use of natural resources and generates electronic waste. Consideration of the environmental impact raises ethical questions that must be addressed to enable sustainable use of AI in medicine.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 3","pages":"165-166"},"PeriodicalIF":39.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Climate change and AKI: heat, hazards and health-system readiness","authors":"Rolando Claure-Del Granado, Nuttha Lumlertgul","doi":"10.1038/s41581-026-01048-2","DOIUrl":"10.1038/s41581-026-01048-2","url":null,"abstract":"Climate change is increasing the risk of acute kidney injury owing to heat stress, infectious and vector-borne diseases, food and water insecurity, pollution and nephrotoxins. Outdoor workers and underserved communities are most affected. Proactive prevention strategies, pathogen-specific care and climate-resilient kidney services can avert avoidable injury, narrow inequities and save lives.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 3","pages":"171-173"},"PeriodicalIF":39.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Environmental stewardship and health systems: Indigenous-centred reflections","authors":"Nicole Redvers, Carol Zavaleta-Cortijo","doi":"10.1038/s41581-026-01049-1","DOIUrl":"10.1038/s41581-026-01049-1","url":null,"abstract":"Environmental sustainability movements have faced criticism for their often mechanical, anthropocentric approach that maintains standards of overconsumption within healthcare and has perpetuated planetary harm. Environmental stewardship, as practised within many Indigenous communities, instead focuses deeply on the interconnectedness of human and planetary health, and offers insights from which the health community can learn.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 3","pages":"167-168"},"PeriodicalIF":39.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tae Won Yi, Vikas S. Sridhar, Jennifer Scott, Massimo Nardone, David Cherney
{"title":"Next-generation therapeutics for diabetic kidney disease","authors":"Tae Won Yi, Vikas S. Sridhar, Jennifer Scott, Massimo Nardone, David Cherney","doi":"10.1038/s41581-025-01042-0","DOIUrl":"10.1038/s41581-025-01042-0","url":null,"abstract":"Diabetes mellitus is the leading cause of chronic kidney disease and kidney failure worldwide, and diabetic kidney disease (DKD) is associated with excess cardiovascular and all-cause mortality. The pathophysiology of DKD is complex and multifactorial, characterized by physiologically redundant haemodynamic, metabolic and inflammatory pathways that promote maladaptive renal remodelling and accelerate disease progression. Current management of DKD centres around four key pillars of guideline-directed medical therapy (GDMT): renin–angiotensin–aldosterone system inhibitors, sodium-glucose cotransporter-2 inhibitors, non-steroidal mineralocorticoid receptor antagonists and glucagon-like peptide-1 receptor agonists. These therapies are increasingly used in combination for cardiorenal protection in DKD. However, substantial residual cardiorenal risk persists even among patients receiving optimal GDMT. Next-generation therapies for DKD that are currently in development include various incretin-based therapies, endothelin receptor antagonists, aldosterone synthase inhibitors, soluble guanylate cyclase agonists and anti-inflammatory agents. These therapies are expected to complement current GDMT and further improve kidney and cardiovascular outcomes in patients with DKD. In this Review, the authors discuss guideline-directed medical therapy for diabetic kidney disease and the evolving clinical evidence for next-generation therapies, including incretin-based therapies, endothelin receptor antagonists, aldosterone synthase inhibitors, soluble guanylate cyclase agonists and anti-inflammatory therapies.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 5","pages":"318-332"},"PeriodicalIF":39.8,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radica Z. Alicic, Joshua J. Neumiller, Katherine R. Tuttle
{"title":"GLP-1 receptor agonists and next-generation metabolic hormone therapies in chronic kidney disease","authors":"Radica Z. Alicic, Joshua J. Neumiller, Katherine R. Tuttle","doi":"10.1038/s41581-025-01036-y","DOIUrl":"10.1038/s41581-025-01036-y","url":null,"abstract":"Chronic kidney disease (CKD) remains a major public health problem, with type 2 diabetes and obesity representing key risk factors worldwide. The complex pathophysiology and the metabolic risk factors shared between type 2 diabetes, obesity, CKD and cardiovascular disease have led to the concept of a cardiovascular–kidney–metabolic (CKM) syndrome. The treatment landscape for CKM changed dramatically when agents from several medication classes, originally developed as glucose-lowering therapies, were recognized to reduce the risk of multiple components of CKM syndrome. Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual glucose-dependent insulinotropic–GLP-1RAs, have evolved from metabolic therapies to agents with either proven or potential protective effects on the kidney and heart. In addition to their potent metabolic actions that reduce hyperglycaemia and body weight, GLP-1RAs also lower the risk of major kidney, cardiovascular and mortality outcomes across broad populations with cardiovascular disease or CKD, with and without diabetes or obesity. GLP-1RAs have been combined with glucose-dependent insulinotropic agonism, as well as glucagon agonism or amylin analogues to further enhance their metabolic benefits. However, kidney and heart protection are not fully explainable by the metabolic actions of these agents. Rather, a growing body of evidence suggests that the systemic and local actions of incretins and metabolic hormones modulate multiple pathways that can promote inflammatory and fibrotic injury. Targeting incretins is emerging as an effective approach to treat cardiovascular–kidney–metabolic syndrome. Here, the authors examine the biological effects of incretins and other metabolic hormones, such as glucagon and amylin, as well as discussing current clinical data demonstrating the organ-protective effects of incretin drugs and their potential underlying mechanisms.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 4","pages":"265-282"},"PeriodicalIF":39.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}