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Adequate nutrition is essential for kidney health; however, attempts to improve nutrition and food security have been hindered in recent years by man-made and natural disasters. Approaches to eradicate famine, improve nutritional status and reduce food insecurity are needed to reduce inequities and maintain kidney health in the face of adverse circumstances.
People with kidney disease are particularly vulnerable to the impacts of natural disasters and extreme weather events. As climate change is increasing the frequency and severity of these events, a robust response is needed to improve disaster preparedness and increase the resilience of these patients.
Climate change is increasing global temperatures and causing more frequent and severe extreme heat events. The resulting additional disease burden is inequitably distributed. Strategies that reduce inequities in heat exposure and vulnerability to heat-related illness, as well as health protections at multiple levels (from individual to regional), are urgently needed to contain the looming crisis.
Thousands of environmental chemicals are used globally. However, despite clear evidence of their adverse effects on the kidney, substantial knowledge gaps remain. Further studies are needed to better understand the effects of chemical mixtures, windows of physiological susceptibility, vulnerable populations, and the intersection of chemical exposure with health risks associated with climate change and heat stress.
Access to essential medical care can be compromised by social disruptions (such as riots and labour strikes), armed conflict and natural disasters, including extreme weather events. A successful response to such events requires forward planning, preparation and rehearsal with involvement of health-care systems, professionals, patients and their support networks. Following execution of the response, after-action evaluation is required to improve future responses.
The COVID-19 pandemic exposed flaws in the ability of the nephrology community to efficiently inform clinical decision making. To improve preparedness for the next pandemic, the nephrology community must work more closely together to ensure that research efforts are aligned and put in place a strategy for the effective dissemination of high-quality evidence in real-time.
The gut microbiota is increasingly recognized as an important factor in human health and disease. Here, the authors focus on the role of the gut microbiome in blood pressure regulation and discuss its clinical implications, as well as the challenges and potential of microbiome research.
This Review describes the global epidemiology, clinical course and key complications of youth-onset type 2 diabetes mellitus. The authors also discuss the mechanisms that might underlie the aggressive clinical phenotype of this disease and current management strategies.
In this Review, the authors discuss the mineral-related factors and kidney-derived molecules that regulate osteocyte FGF23 production in health and disease. They also highlight potential approaches to the treatment of FGF23-related disorders of mineral metabolism that target key bone–kidney interactions.
Primary hyperoxaluria is an inherited disorder that results from the overproduction of endogenous oxalate, leading to recurrent kidney stones, nephrocalcinosis, kidney failure and life-threatening systemic disease. This Consensus Statement from ERKNet and OxalEurope provides recommendations for the management of primary hyperoxaluria, including consideration of conventional therapies, new therapies and recommendations for patient follow-up.
