Renal replacement therapy articles from across Nature Portfolio

First Nations peoples in Australia face systemic inequities in access to kidney transplantation. The National Indigenous Kidney Transplant Taskforce was established to address these. It has provided support to clinicians to implement and evaluate innovative practices and developed strategies to address biases in the structures and models of care that create barriers to wait-listing.

Among global destabilizing events, natural disasters often receive widespread attention whereas protracted conflicts and economic crises fade into the background. Low- and middle-income countries bear the brunt of this indifference, resulting in severely weakened health systems. People who require dialysis are particularly vulnerable, necessitating urgent collaboration to ensure equitable and sustainable care during such crises.

Racial and ethnic minoritized populations are underrepresented in clinical trials in nephrology, but overrepresented in adverse kidney disease outcomes. Targeted enrolment, revision of problematic policies, inclusion of minoritized populations in trial planning, and language-, race- and ethnicity-concordant investigative teams can improve representation in clinical trials.

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.