Nephrology research—the past, present and future

Abstract

Important advances have been made in basic and clinical nephrology research over the past decade, with improved pathological insights into various disease processes and the introduction of new treatments for diseases such as atypical haemolytic uraemic syndrome. However, many challenges remain. In this Viewpoint, we asked five Nature Reviews Nephrology Advisory Board members, who have been associated with the journal since its launch in November 2005, to reflect on the progress and roadblocks of the past 10 years. They also comment on areas where effort and money should be invested and how they expect the field to progress in the next 10 years.

Guidelines for clinical evaluation of chronic kidney disease

“…The general conclusion of these papers supported 30-40% decrease in eGFR as a surrogate endpoint of ESRD [12]. This conclusion was generally well received by researchers and drug regulatory authorities [13][14][15].…”

Cellular plasticity: A mechanism for homeostasis in the kidney

“…Cells of the kidney have the ability to switch cell type depending on environmental cues and do so in a localization and cell type‐specific manner. Cell plasticity in adult tissues is of great interest for regenerative medicine in nephrology . These recent discoveries about cell plasticity in the glomerulus and tubules indicate that kidney has a constitutive ability to repair; though that ability is overcome by deleterious mechanisms in long‐term diseases.…”

The biobank for the molecular classification of kidney disease: research translation and precision medicine in nephrology

“…With the recent expansion in systems biology and precision medicine approaches in nephrology research and clinical practice, the demand for biobanking is increasing [7–10, 14]. The BMCKD infrastructure will provide critical support for translational research and precision medicine in nephrology through its capability to process and store patient biospecimens that includes kidney tissue, cells, blood, urine, DNA, RNA and protein.…”

“…To date, the majority of kidney diseases are diagnosed on morphological or clinical grounds with only general biomarkers available to stratify risk, guide care, and monitor therapy. Furthermore, due to an inadequate understanding of disease pathogenesis and a paucity of specific biomarker developments, treatment options are generally non-specific (e.g., use of steroids or anti-proliferative agents) and applied broadly with limited success [2, 6, 7]. …”