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Laura H. Mariani, Laura Barisoni, Debbie S. Gipson, Lawrence B. Holzman, Crystal Gadegbeku, John R. Sedor, and Matthias Kretzler

Patients with newly diagnosed nephrotic syndrome due to minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and membranous nephropathy (MN) display an impressive amount of variability in disease severity, symptom burden, response to initial therapy, and risk of relapse. Although this heterogeneity is a clinical challenge—frustrating patients and clinicians alike—it is also an opportunity for researchers to partner with patients under routine clinical care to collect the data and bio-samples needed to better define mechanistically relevant subgroups. The Nephrotic Syndrome Study Network (NEPTUNE) is a North American multi-center collaborative consortium that was established to develop such a translational research infrastructure

Hongxia Fu and Benjamin S. Freedman

Ten years ago, human kidney organoids were but twinkles in the eyes of a few intrepid inventors. Now, these tiny collections of cells, which bear a striking resemblance to kidney tissue, are well on their way to becoming a standard research tool. As they spread, kidney organoids are also becoming more diverse and gaining new abilities.

The ability of organoids to mimic features of kidney diseases presents new opportunities to discover medications and exciting possibilities for regenerative medicine. To generate the structures more reproducibly and optimize their shapes and sizes, a technique, called cellular extrusion bioprinting, has recently been introduced

Collin Jordan and Xunrong Luo

For the greater part of the 20th century, exogenous insulin administration and whole organ pancreatic transplantation served as the predominant therapeutic interventions for patients with type 1 diabetes mellitus. The success of the Edmonton group in achieving insulin independence in the early 2000s via islet cell transplantation in a cohort of patients with autoimmune diabetes led to renewed optimism that this treatment could serve as an alternative to solid organ transplantation (1). However, 16 years later, a shortage of donor pancreatic islet cells remains a major challenge in increasing the scale of human allogeneic islet transplantation.

Various novel

Matthew A. Sparks and Jennie J. Lin

Basic science is fundamental to advancing medicine and improving health outcomes. It is an exciting time to be engaged in basic and translational research focusing on kidney diseases. Novel research tools and methodologies are available to answer questions that have long eluded scientists. Moreover, we are seeing investments in kidney-related research by pharmaceutical companies, industry, societies, and governments. Examples of these investments include the Kidney Precision Medicine Project (KPMP), funded by the National Institute of Diabetes and Digestive and Kidney Diseases; the Transformative Research in Diabetic Nephropathy (TRIDENT) study, which is a private-public partnership; the Kidney Innovation Accelerator (KidneyX) prize;

Eryn E. Dixon

The advancements of single-cell and nucleus RNA sequencing (sc/snRNAseq) have shifted our approach to defining cell types and states relevant to human health. These technologies have provided detailed insight into the transcriptome (all of the expressed messenger RNA [mRNA] of a single cell, tissue, or sample) of a single cell. However, this process, requiring dissociation of tissue to the level of the single cell or nucleus, obscures the structural context of each cell within the tissue. Therefore, sc/snRNAseq studies have been limited by their inability to capture data essential to understanding these cellular microenvironments (surrounding cells, extracellular matrix, and signaling

Kiri Bagley and Brianna Borsheim

Twenty percent of Americans live in rural areas. Many face health disparities caused by geographic isolation, transportation limitations, and a lack of access to local specialty health care (1, 2). Americans living in rural areas also are more likely to be uninsured, to have lower rates of access to preventive health services, and to engage in unhealthy behaviors (such as tobacco use) (25). They also have greater incidence rates of potentially preventable diseases, including heart disease and stroke, and higher mortality rates than their urban counterparts (2, 4,

Dinushika Mohottige and Mitchell R. Lunn

Lesbian, gay, bisexual, transgender, queer or questioning, and/or other sexual and gender minority (SGM) individuals (LGBTQ+) represent a diverse range of people who experience disparities in health outcomes and other health-promoting resources and opportunities and are served by kidney care professionals (13).

Although there have been advances in civil rights legislation, including same-sex marriage equality aimed to equalize some sociopolitical opportunities, there are innumerable persistent social, economic, legal, health, and health care-related disparities facing SGM individuals (2, 4). These challenges are exemplified by a patchwork of non-discrimination policies across the United States

Andrea Kattah

The challenges for women in medicine are well documented: Women get paid less than men (1, 2). Women are under-represented in leadership positions at academic institutions (3, 4). Women bear more of the burden at home in dual professional households (5). The headlines are so familiar that it can be difficult for one to muster outrage. Although there are increasing victories in the struggle for equality, such as the inclusion of female voices on academic panels, systemic changes are needed to level what has historically been an uneven playing field.

Tod Ibrahim

In 1960, my father immigrated to the United States to avoid religious persecution, experienced racism in Ohio, overstayed his student visa, and was considered “illegal.” My mother—whose family has deep, often racist, roots in the United States—eloped with my father, helped him become a US citizen, experienced sexism (especially in the workplace), worked for two female members of Congress, and volunteered as a counselor during the AIDS crisis.

Their individual and shared experiences shape my commitment to diversity, equity, inclusion, and justice. The American Society of Nephrology (ASN) was a pacesetter—and is now an advocate—in this arena because its members,

Nadia McLean and O’Neal Malcolm

Chronic kidney disease (CKD) is a significant cause of morbidity and mortality worldwide. The global burden of CKD is estimated at 500 million people worldwide, with the majority of people with CKD (80%) living in low- and middle-income countries (LMICs) (1). In 2017, 1.2 million people died from CKD, with the all-age mortality rate increasing 41.5% between 1990 and 2017 and a global prevalence of 9.1%. The global all-age prevalence of CKD also represented an increase of 29.3% since 1990 (2). Along with the noted increases, there is inequity in the distribution of CKD; people living