The Nephrology Match yielded disappointing results again this year.

This is a highly exciting year for nephrology. We will all need not only to watch but to participate in bringing about positive changes in healthcare for preventing and treating kidney diseases, hoping for strong support from the Advancing American Kidney Health initiative. One of the strongest reasons for enthusiasm, and one of the most important aspects, will be advancing clinical trials in nephrology.

Only recently, clonal hematopoiesis of indeterminate potential (CHIP) has been proposed as a novel cardiovascular risk factor linking the innate immune system with aging and vascular inflammation (1, 2).

Nephrology has constantly fought against, and sometimes succumbed to, a narrative of decline and stagnation. There is a complaint that new therapies are not being developed or approved, there has been a paucity of successful clinical trials, and in-center dialysis remains the standard of care for kidney failure. It is time to put this negative narrative to rest.

Decreased exercise capacity and cardiovascular risk are integral features of chronic kidney disease (CKD), with a debilitating impact on quality of life and survival.

As representatives of the US Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and Center for Medicare and Medicaid Innovation (CMMI) joined the audience of thousands in the nephrology community from around the world, ASN President Mark E.