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  • Understanding of the pathogenesis of membranous nephropathy has improved substantially, thanks to the discovery of pathogenic circulating autoantibodies against endogenous antigens. This Review provides an overview of the immunological processes involved in the aetiopathogenesis of membranous nephropathy, including loss of immune tolerance, genetic susceptibility factors and the role of autoantibody binding in the kidney.

    • Elion Hoxha
    • Linda Reinhard
    • Rolf A. K. Stahl
    Review Article
  • Advancing kidney health justice for all requires the kidney-care community to embrace gender-affirming care across the life course, including inclusion of gender minority individuals in research, thoughtful attention to sexual-orientation and gender-identity data collection, as well as the promotion of policies and practices that protect and provide comprehensive care to all patients.

    • Han E. Eckenrode
    • Joseph T. Flynn
    • Dinushika Mohottige
    Comment
  • Emerging evidence suggests that artificial intelligence (AI)-enabled decision support systems may have an important role in the diagnosis, prognosis and treatment of kidney diseases. This Review provides an overview of AI fundamentals and the state of the art of AI-enabled decision support systems in nephrology.

    • Tyler J. Loftus
    • Benjamin Shickel
    • Azra Bihorac
    Review Article
  • People with chronic diseases are at high risk of becoming innocent victims of the Russian–Ukrainian war, owing to interruption of their health care. More than 10 million Ukrainian people have left their homes and almost 5 million have left the country. Provision of kidney care for these refugees is an emerging challenge.

    • Giorgina B. Piccoli
    • Giuliano Brunori
    • Kamyar Kalantar-Zadeh
    Comment
  • People who identify as sexual and/or gender minority individuals face unique and challenging inequities in access to health care. They experience bias, discrimination and underinsurance, which limits their access to high-quality care (including for kidney disease). These inequities must be addressed through the provision of safe and inclusive environments, improved identification of disparities and the creation of a pipeline of equity-focused leaders.

    • Juan D. Salcedo-Betancourt
    • Samira S. Farouk
    • Yuvaram N. V. Reddy
    Comment
  • Sexual and/or gender minority health-care workers are subject to the heteronormativity and cisnormativity of society and often face open discrimination. Empowering these individuals to bring their full, authentic selves to work so that they can serve their patients and institutions with the totality of their strengths requires institutes and cisgender or straight allies to support LGBTQ+ communities by creating a culture of inclusivity and enacting progressive policies.

    • Mackenzie H. Holmberg
    • Suzanne G. Martin
    • Mitchell R. Lunn
    Comment
  • Patients with kidney disease are at particular risk of the adverse outcomes of COVID-19. Throughout the pandemic, epidemiological studies have been performed to inform clinical care; however, these studies have faced a number of methodological challenges. This Review discusses current understanding of the effects of COVID-19 on patients with kidney disease and some of the major obstacles encountered when conducting epidemiological research in a pandemic setting.

    • Viyaasan Mahalingasivam
    • Guobin Su
    • Dorothea Nitsch
    Review Article
  • The COVID-19 pandemic has highlighted the vital role of vaccination in preventing life-threatening diseases and improving global health. Understanding and addressing the concerns of vaccine-hesitant individuals, including those with chronic diseases, is key to increasing vaccine acceptance and uptake.

    • Eve Dubé
    • Noni E. MacDonald
    Comment
  • Drosophila melanogaster can be a useful experimental model in nephrology. Here, the authors examine the fly renal system, focusing on the Malpighian tubules and nephrocytes, and discuss its advantages and limitations as a model system and the mechanistic insights into kidney disease that they have provided.

    • Julian A. T. Dow
    • Matias Simons
    • Michael F. Romero
    Review Article
  • Here, the authors describe the determinants of ‘absolute’ and ‘relative’ glomerular hyperfiltration and discuss single-nephron haemodynamic changes as pathophysiological factors that might result in progressive kidney injury. They also explain how interventions that mitigate glomerular hyperfiltration might translate into long-term renoprotection.

    • Monica Cortinovis
    • Norberto Perico
    • Giuseppe Remuzzi
    Review Article
  • In this Review, the authors focus on kidney involvement in Chagas disease, filariasis, leishmaniasis, malaria and schistosomiasis. They describe the epidemiology, clinical features, mechanisms of kidney injury and renal pathological aspects of these diseases.

    • Elizabeth De Francesco Daher
    • Geraldo Bezerra da Silva Junior
    • Vivekanand Jha
    Review Article
  • Advances in the field of single-cell genomics and spatial technologies have enabled dissection of the cellular heterogeneity of complex tissues, including the kidney. This Review summarizes the state of the art of single-cell analyses in kidney research, including advances in our understanding of kidney embryogenesis and pathomechanisms of several relevant kidney disease entities.

    • Felix Schreibing
    • Rafael Kramann
    Review Article
  • Decades of research have revealed that nephron number is a crucial determinant of kidney health. However, a lack of appropriate tools has limited these studies to ex vivo analyses. For the first time, techniques are emerging that might enable the use of functional nephron number as a biomarker in living humans.

    • Kevin M. Bennett
    • Edwin J. Baldelomar
    • Jennifer R. Charlton
    Comment