Chronic kidney disease represents a growing global health challenge and people progressing to kidney failure rely on dialysis – but access is limited in many ...

Chronic kidney disease represents a growing global health challenge and people progressing to kidney failure rely on dialysis – but access is limited in many ...

Nature Reviews Nephrology, Published online: 21 January 2026; doi:10.1038/s41581-025-01032-2Dialysis 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.

Nature Reviews Nephrology, Published online: 15 January 2026; doi:10.1038/s41581-026-01047-3Artificial 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.

Nature Reviews Nephrology, Published online: 20 January 2026; doi:10.1038/s41581-026-01051-7Low- 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.

Nature Reviews Nephrology, Published online: 20 January 2026; doi:10.1038/s41581-026-01050-8An 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.

Nature Reviews Nephrology, Published online: 14 January 2026; doi:10.1038/s41581-026-01048-2Climate 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.

Nature Reviews Nephrology, Published online: 14 January 2026; doi:10.1038/s41581-026-01049-1Environmental 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.

Nature Reviews Nephrology, Published online: 19 January 2026; doi:10.1038/s41581-026-01054-4Chronic 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.

Nature Reviews Nephrology, Published online: 12 January 2026; doi:10.1038/s41581-025-01042-0In 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.

Nature Reviews Nephrology, Published online: 15 January 2026; doi:10.1038/s41581-026-01047-3Artificial 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.

Nature Reviews Nephrology, Published online: 14 January 2026; doi:10.1038/s41581-026-01048-2Climate 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.

Nature Reviews Nephrology, Published online: 14 January 2026; doi:10.1038/s41581-026-01049-1Environmental 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.

Nature Reviews Nephrology, Published online: 08 January 2026; doi:10.1038/s41581-025-01036-yTargeting 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.

Nature Reviews Nephrology, Published online: 12 January 2026; doi:10.1038/s41581-025-01042-0In 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.

Nature Reviews Nephrology, Published online: 05 January 2026; doi:10.1038/s41581-025-01038-wIn this Perspective, the authors explore the concept of multifactorial chronic kidney disease and examine the different factors that might compromise kidney functional capacity or increase kidney workload throughout the life-course, and how their cumulative effects can lead to chronic kidney disease.

Nature Reviews Nephrology, Published online: 05 January 2026; doi:10.1038/s41581-025-01034-0Here, the authors discuss how to implement quality-focused dietary strategies for patients with chronic kidney disease. They discuss the principles of dietary balance, variety and moderation, food processing and cooking methods and approaches to enabling successful implementation of quality-focused dietary strategies.

Nature Reviews Nephrology, Published online: 08 January 2026; doi:10.1038/s41581-025-01036-yTargeting 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.

Nature Reviews Nephrology, Published online: 05 January 2026; doi:10.1038/s41581-025-01038-wIn this Perspective, the authors explore the concept of multifactorial chronic kidney disease and examine the different factors that might compromise kidney functional capacity or increase kidney workload throughout the life-course, and how their cumulative effects can lead to chronic kidney disease.

Nature Reviews Nephrology, Published online: 05 January 2026; doi:10.1038/s41581-025-01034-0Here, the authors discuss how to implement quality-focused dietary strategies for patients with chronic kidney disease. They discuss the principles of dietary balance, variety and moderation, food processing and cooking methods and approaches to enabling successful implementation of quality-focused dietary strategies.

Nature Reviews Nephrology, Published online: 17 December 2025; doi:10.1038/s41581-025-01045-xKidneys 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.

Nature Reviews Nephrology, Published online: 16 December 2025; doi:10.1038/s41581-025-01044-yCardiovascular–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.

Nature Reviews Nephrology, Published online: 15 December 2025; doi:10.1038/s41581-025-01043-zIn 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.