More than 70% of greenhouse gas emissions from kidney care come from the supply chain, making procurement systems a key opportunity to reduce environmental impact. 

A new GREEN-K paper in Kidney International Reports® describes how the ISN-led GREEN-K Working Group developed a proposed global sustainable procurement framework for kidney care.     

Read the paper 

The authors combined an environmental scan with expert interviews and broad consultation across the clinical and industry communities to develop and refine a sustainable procurement framework.  

The paper outlines six areas for more sustainable procurement: decarbonization, supply chain ethics, circularity, health equity, climate resilience, and protection of the living planet. These principles will inform the GREEN-K Joint Statement on Procurement, which will be launched in November. 

Read more about the ISN-led GREEN-K Initiative

Speakers and delegates at the International Expert Forum: Complement Therapeutics in Clinical Practice in Kidney Disease in Singapore

As complement therapeutics expand across kidney diseases, how should clinicians decide when to use them, how to monitor response, and when to change or stop treatment? 

From September 16-18, 113 experts from 32 countries gathered in Singapore for the ISN International Expert Forum: Complement Therapeutics in Clinical Practice in Kidney Disease to examine these questions and other challenges in using complement-targeting therapies in clinical practice. 

The program covered current evidence for complement therapeutics in aHUS, C3G/IC-MPGN, IgAN, and ANCA-associated vasculitis. It also explored the role of complement in FSGS, diabetic nephropathy, membranous nephropathy, and lupus nephritis. In addition, discussions addressed optimal combination therapies and priorities for future clinical trials.  

The ISN International Expert Forum series brings together leading experts from around the world to examine recent developments, areas of debate, and unmet needs in focused areas of kidney care, helping connect emerging evidence with questions arising in clinical practice. 

The ISN thanks the steering committee, speakers, moderators, and attendees, as well as the event supporters: Alexion, AstraZeneca Rare Disease, Novartis, Biogen, Novo Nordisk, Otsuka, Roche, Sobi, Kira Pharmaceuticals, Bisirna, and Sitala.

 

The ISN’s practical kidney care “cheat sheets” for primary care are now available in French and Spanish, alongside the original English version, making it easier to share clear, concise kidney care guidance with primary care colleagues in different geographies. Japanese, German, and Chinese translations will follow soon. 

Explore the “cheat sheets” and share them with your primary care colleagues 

Designed as quick-reference resources for primary care, the three tools cover:  

• Early identification of kidney disease 

• Cardio-kidney-metabolic health 

• Kidney replacement therapies and conservative kidney management  

They support earlier detection, informed management, and timely referrals by turning complex guidance into practical information for everyday use. 

These resources were developed with support from the ISN Strategic Partner Program. 

Concerned about the environmental impact of kidney care but unsure where to start? The ISN Green Nephrology Toolkit offers practical guidance to help healthcare professionals introduce simple, sustainable changes within their kidney care units.  

Explore the toolkit  

Developed in collaboration with the ISN Emerging Leaders Program cohort 2 with support from the GREEN-K* steering committee, the toolkit is designed for teams at any stage of their sustainability journey, providing knowledge, examples, and a clear framework to support more environmentally responsible kidney care. It covers key areas such as forming a green committee, assessing local priorities, improving waste management, reducing resource use, and measuring progress. 

In addition, a series of infographics translates key elements from the toolkit into accessible, shareable formats that can be used to engage colleagues, trainees, and wider healthcare teams. 

Explore the infographics 

These resources aim to help kidney care teams turn sustainability goals into practical action, supporting greener, more responsible care for patients and communities without compromising quality of care. 

Other GREEN-K resources 

Follow the ISN ELP-GREEN-K Initiative – Global Environmental Evolution in Nephrology and Kidney Care Curriculum 

Explore articles on kidney care and climate change 

*The Global Environmental Evolution in Nephrology and Kidney Care (GREEN-K) initiative promotes sustainable, resilient kidney care worldwide through advocacy, education, and collaboration, working toward its vision of “sustainable kidney care for a healthy planet and healthy kidneys.” 

 

Pregnancy-associated acute kidney injury (PrAKI) remains a major contributor to maternal and perinatal morbidity worldwide, yet its true global burden has never been captured in a single, coordinated dataset. Developed with ISN support, the first PrAKI Global Snapshot will help address this gap through an international, non-interventional service evaluation using anonymized, routinely collected clinical data. 

Building on the existing partnership between the ISN and the Global PrAKI Consortium to improve maternal kidney health, the project responds to calls from the 2025 ADQI-32 and KDIGO Controversies Conference for stronger epidemiological data on the incidence, risks, and outcomes of PrAKI. 

Can you participate in the PrAKI Global Snapshot? 

Find out more and register by May 31, 2026, to participate 

The study* will take place in two phases: 

• Phase 1: From September to November 2026, participating sites will select a four-week window to enter data on all women with confirmed or suspected PrAKI, alongside a daily denominator of admissions 

• Phase 2: From March to May 2027, the process is repeated to help capture seasonal and contextual variations 

Participation is designed to be feasible across settings. Each site needs: 

• One named lead 

• An estimated 15 to 20 minutes of data entry per case  

• No minimum case number 

• A data collection window chosen by the site  

Can you become a regional lead for the initiative? 

The consortium is also seeking regional leads across 14 regions worldwide to support engagement with ministries, professional societies, and partners, and help ensure regional perspectives shape the global strategy.  

This voluntary role requires around four to six hours per month. It is open to clinicians, midwives, nurses, researchers, policymakers, global health leaders, and others with relevant networks and an interest in maternal kidney health. 

To apply, send a short video (under three minutes), in any language, via WhatsApp (+65 8870 5154) explaining:  

• Why you care about the initiative
  • What you hope to achieve
  • Why you are the right person for the role 

By joining as a participating site, a regional lead, or both, you can help generate the first coordinated global picture of pregnancy-associated AKI and support efforts to improve maternal kidney health worldwide. 

*The UK coordinating center has classified the PrAKI Global Snapshot as a clinical audit/service evaluation; participating sites remain responsible for confirming local governance requirements. 

 

 

Primary care is often the first point of contact for people with emerging health concerns, making primary care physicians central to the early detection and long-term management of kidney disease. 

Early identification in these settings is critical, as many kidney diseases are diagnosed at later stages, while timely intervention can slow progression and improve outcomes. 

The ISN has developed a series of practical kidney care “cheat sheets” for primary care, turning complex guidance into clear, easy-to-use references that support earlier detection, better management, and improved patient outcomes. 

Explore and share the cheat sheets 

What the cheat sheets cover 

• Early identification of kidney disease 

Clear guidance on how and whom to assess, how to determine the underlying cause, and when to refer to help prevent progression and reduce complications. 

• Cardio-kidney-metabolic health 

A holistic approach to managing interconnected kidney, cardiovascular, and metabolic conditions, combining lifestyle interventions and guideline-directed therapies to improve long-term outcomes. 

• Kidney replacement therapies and conservative care 

Guidance on approaching kidney failure, including shared decision-making around dialysis, transplantation, and conservative care, aligned with patient preferences and quality of life. 

The ISN encourages all to share the cheat sheets with their primary care colleagues. 

These resources were developed with support from the ISN Strategic Partner Program. 

 

ISN member Kristin Veighey presents at the ISN-EFIM joint session at ECIM 2026

 At the European Congress of Internal Medicine (ECIM) 2026, the ISN and the European Federation of Internal Medicine (EFIM) held a joint session highlighting the importance of kidney health in internal medicine.  

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Janaka Karalliedde  speaks at the ISN-EFIM joint session at ECIM 2026 

Building on past joint sessions at ECIM, the session, “Chronic kidney disease (CKD) – what every internist needs to know,” focused on how to recognize, assess, and manage CKD in everyday clinical practice. ISN member Kristin Veighey (UK) and Janaka Karalliedde (UK), associate editor for the EFIM academy, delivered the talks, emphasizing the importance of early identification and integrated care.

As part of her presentation, Dr. Veighey presented the ISN’s kidney care cheat sheets for primary care. These practical tools turn complex guidance into clear, easy-to-use references to support earlier detection, better management, and timely referral. 

By working together through initiatives like this, the ISN and the EFIM are strengthening cross-specialty collaboration to help improve kidney health outcomes. 

What if better research approaches could help take the “unknown” out of chronic kidney disease of unknown etiology (CKDu)? 

Launched at WCN’26, the new ISN i3C CKDu Toolkit* is designed to help build research capacity in CKDu-endemic regions by strengthening study design and implementation through consistent approaches to case definitions, exposure assessment, and outcome measurement. 

Explore the ISN i3C Toolkit 

It offers practical guidance to strengthen the rigor, consistency, and comparability of CKDu research across studies and settings by: 

1. Developing laboratory and pathology infrastructure 
2. Adopting validated biomarkers where feasible 
3. Following good practices for collecting, storing, and managing biological samples  

What you will find in the toolkit 

Drawing on the ISN i3C’s principal publications, you’ll get step-by-step guidance on: 

• Epidemiologic, molecular, and genetic methods 

• Disease detection and minimum datasets 

• Ethics in CKDu research 

• Kidney biopsy best practice in endemic regions 

• Interventional study design 

• Multicountry cohort design 

The toolkit is designed to support harmonized but adaptable approaches across diverse settings, while promoting equitable participation, ethical research practice, and capacity building in the regions most affected. 

By helping to bring greater consistency, practicality, and equity to CKDu research, the toolkit can help teams produce stronger evidence and move the field closer to clearer answers. 

*The toolkit was developed by ISN i3C CKDu Working Group member Ana Catalina Alvarez Elias (US), with support from incoming chair Ben Caplin (UK) and outgoing chair Eranga Wijewickrama (Sri Lanka). 

Further reading 

Taking the “unknown” out of CKDu — optimizing approaches to uncover the cause(s) of epidemic-level kidney disease in low- and middle-income settings: a report from the ISN’s International Consortium of CKDu Collaborators (ISN i3C) 

The ISN “Are your kidneys healthy?” quiz webpage has been refreshed with a new design that makes key kidney health information easier to explore. 

Access the “Are your kidneys healthy?” quiz 

Available in 35 languages, the quiz helps better understand kidney function, risk factors, and steps they can take to protect their kidney health.  

Share the quiz with your patients to open a dialogue about kidney disease and the importance of early detection. Pass the link along to colleagues in your institution so they can use it in their own patient education. 

The “Are your kidneys healthy?” quiz is supported by unrestricted educational grants from Boehringer Ingelheim and Otsuka. 

                     

The ISN-led GREEN-K* (Global Environmental Evolution in Nephrology and Kidney Care) initiative invites the global kidney community to review and comment on a joint draft statement, “Procurement for Environmentally and Ethically Sound Kidney Care Products and Services.” 

Read the draft statement and share your feedback by March 30 

The goals of the procurement strategy: 

• Introduce a joint procurement concept that benefits all kidney care stakeholders 

• Drive improvements in sustainability, equity, and climate resilience across kidney care products and services 

• Provide kidney care programs and procurers with expert-derived, forward-looking procurement criteria 

Why procurement matters 

More than 70% of health and kidney care emissions originate upstream or downstream of direct patient care, and higher environmental impacts are often linked to higher financial costs. The World Health Organization has also positioned health systems as a critical part of the climate solution, with procurement playing an important role in driving innovation and sustainability. 

Thank you in advance for helping shape this initiative 

*GREEN-K is a global, collaborative initiative that aims to improve global kidney health by increasing access to, and the affordability and environmental performance of kidney care goods and services. 

 

Looking to strengthen your confidence in diagnosing and managing glomerular diseases? The ISN Primer Course in Glomerular Diseases offers an intensive, case-based learning experience designed to sharpen clinical decision-making and connect you with international faculty and peers. 

Applications are now open for the next edition of the course in Montevideo, Uruguay, from August 8–9, 2026. 

Find out more and apply by March 23, 2026 

From early recognition and risk stratification to optimizing therapy in complex cases, this two-day in-person program features interactive sessions and expert-led discussions focused on real-world approaches to glomerular diseases.  

Travel grants are available to support selected applicants. 

Places are limited. If you are eager to deepen your expertise in glomerular disease and engage directly with leading faculty, we encourage you to apply early. 

The following company has provided funding towards this independent course and has had no editorial input or control over the program, content development, or choice of expert speakers: Otsuka. 

Speakers and moderators at the ISN Expert Forum on B cell targeting in glomerular disease 

What do clinicians and researchers need to know about B cell biology and targeting as options for glomerular disease continue to evolve? From January 29-31, 111 experts from 27 countries gathered in Seville, Spain, for the ISN Expert Forum on B Cell Targeting in Glomerular Disease: A New Era in Treatment, a focused exchange on current evidence, emerging approaches, and unmet needs in this rapidly developing area.  

Through a series of in-depth and interactive sessions, kidney care experts were joined by specialists from related disciplines, including rheumatology, immunology, and hematology-oncology. This cross-disciplinary exchange enriched discussions on B cell biology and function, methods for assessing B cell activity, and therapeutic applications. Discussions also addressed the state of B cell targeting in glomerular disease and key questions shaping future research and clinical practice. 

The ISN Expert Forum is one of the ways the ISN drives quality improvements in kidney care through connecting its community with the latest research, therapies, expertise and networking opportunities.  

The ISN thanks the steering committee, speakers, moderators, and attendees, as well as the event supporters, Vera Therapeutics, Otsuka, Jade Biosciences, Biogen, Novartis, Takeda, Alexion, Roche, and Climb Bio. 

 

Delegates and faculty at the ISN Primer Course in Glomerular Diseases in Taipei, Taiwan 

 The latest edition of the ISN Primer Course in Glomerular Diseases took place in Taipei, Taiwan, as a pre-congress course at the 23rd Asian Pacific Congress of Nephrology in conjunction with the Annual Meeting of Taiwan Society of Nephrology, bringing together 99 delegates from 15 countries, along with faculty and representatives from supporting partners. 

The course provided clinicians with up-to-date guidance on diagnosing, interpreting, and managing the full spectrum of glomerular diseases, with opportunities to discuss case-based management directly with experts.  

Planning is now underway for the upcoming 2026 editions — in Uruguay, China, and as a WCN’26 satellite course in Yokohama, Japan. 

The course is open exclusively to ISN members. Join or renew your ISN membership to be eligible for ISN courses and grant programs. 

Read about past editions of the ISN Primer Course in Glomerular Diseases 

This course was made possible with support from Alexion AstraZeneca Rare Disease, Novartis, Otsuka, Vera Therapeutics, and Vertex. 

The ISN “Are Your Kidneys Healthy?” quiz is now available in Swahili! 

These quick and informative questions, offered in 32 languages, help individuals assess their risk of kidney disease and take proactive steps for kidney health. 

If you would like to contribute by translating the quiz into another language, please contact Romane at rblondel@theisn.org.  

Want quick, reliable references to guide multidisciplinary treatment decisions? The ISN Optimization of SGLT2i Therapy Toolkit provides handy infographics designed to help nephrologists, cardiologists, and other healthcare professionals optimize patient care across kidney, heart, and metabolic conditions. 

Access the tools in English, German, and Spanish  

Key topics covered include: 

• Nuts and bolts of SGLT2i therapy at the intersection of kidney and cardiovascular disease 

• Mitigating the adverse effects of SGLT2 inhibitors 

• SGLT2 inhibitor cold map 

• Talking to patients about SGLT2i therapy 

Developed in collaboration with leading nephrology and cardiology societies, the toolkit is part of the ISN’s broader initiative to advance integrated care for patients with cardio-kidney-metabolic (CKM) complications. It gives clinicians practical, evidence-based guidance to make more confident, timely decisions in the management of complex CKM patients. 

The Optimization of SGLT2i Therapy Toolkit is supported by unrestricted educational grants from AstraZeneca and Boehringer Ingelheim and its alliance partner, Lilly.   

 

 

The deputy minister of health and staff from the Health Department, Tajikistan, visit a new hemodialysis center opened with support from the ISN SRC Program  

Irma Tchokhonelidze observed significant gaps in dialysis provision during her 2021 visits to kidney centers in Dushanbe, including limited diagnostic capacity, the absence of patient registries, and inconsistent follow-up in largely private dialysis facilities. As past chair of the ISN Dialysis Working Group, Dr. Tchokhonelidze recognized the need for a coordinated national approach and met with the Ministry of Health to advocate for support and to introduce the ISN Dialysis Framework. 

Dr. Tchokhonelidze (center) in discussions with the deputy minister of health (far right) at the Ministry of Health 

The Ministry expressed strong interest in the ISN Dialysis Framework’s recommendations, particularly for chronic kidney disease screening in primary care and integrated kidney replacement therapy. Since then, the Ministry of Health has made incremental progress in developing qualified nephrology services, designating a department within the largest regional hospital as a “hub” for the ISN Sister Renal Centers (SRC) trio partnership* and ensuring ongoing support for the program. The SRC collaboration is helping to advance kidney services at the State Institution National Medical Center in Tajikistan.  

“We’re confident that training, education, and collaborative efforts will thrive under government oversight,” said Dr. Tchokhonelidze. 

Tajikistan’s experience demonstrates how raising awareness about the ISN Dialysis Framework can drive government action and sustainable kidney care development in resource-limited settings. 

About the Dialysis Framework 

The ISN Framework for Developing Dialysis Programs in Low-resource Settings, endorsed by the World Health Organization, is a practical guide designed to help governments establish equitable, effective dialysis systems and long-term national kidney care strategies. Its guidance is especially relevant in contexts where national kidney care programs remain fragmented, often relying on private dialysis providers with limited public oversight.  

*The trio is an expansion of the Belgium–Georgia SRC partnership, which has now graduated and received the ISN Schrier Award in 2023. 

 

 

 

 

A new cohort of trainees has been accepted into the program and will receive guidance from members of the inaugural cohort, now serving as faculty alongside senior mentors.  

The ISN Train-the-Trainer program in pregnancy and kidney diseases, led by Shilpa Jesudason (Australia) and Michelle Hladunewich (Canada), aims to build a robust network of professionals well-versed in the intricate relationship between pregnancy and kidney disease who can, in turn, train and educate future generations.  

Learn more about the program. 

The first cohort completed a series of curriculum-focused activities that culminated in the launch of the Pregnancy and Kidney Disease Toolkit at WCN’25. Dr. Jesudason and Dr. Hladunewich will present the session “Pregnancy and Kidney Disease: Rapid Fire Update!” at WCN’26. 

More resources 

Explore the Pregnancy and Kidney Disease Toolkit 

Listen to a podcast on the Train-the-Trainer program 

Follow the “ISN Pregnancy and Kidney Disease Toolkit Curriculum” at the ISN Academy 

For more information or to get involved in the Train-the-Trainer program, contact ebrigneti@theisn.org or education@theisn.org. 

 

Early detection of CKD can save lives and reduce healthcare costs by slowing progression, preventing complications, and avoiding costly dialysis or transplantation. Utilize the Starting and Sustaining Early CKD Detection and Intervention Programs Toolbox to address CKD detection gaps rand help improve care for those at risk. 

Designed as a set of building blocks, the toolbox allows you to begin with the element most relevant to your setting — whether identifying at-risk populations, selecting testing methods, securing stakeholder support, or integrating care with other services. Each section links to evidence-based resources that may be adapted to different healthcare contexts, helping teams design effective and sustainable programs. 

Access the toolbox  

This toolbox is part of the broader ISN-KDIGO CKD Early Identification & Intervention Toolkit. 

Additional resources 

Access ISN Webinars on implementing early CKD detection programs around the world. 

The ISN-KDIGO CKD Early Identification & Intervention Toolkit is supported by an independent grant from Boehringer Ingelheim and Lilly. 

As we observe World Heart Day, today, September 29, the ISN underscores the critical intersection of cardiovascular and kidney health through its Cardio-Kidney-Metabolic (CKM) Initiative.  

The ISN encourages healthcare professionals worldwide to integrate the CKM tools into their practice. By doing so, clinicians can refine their approach to treating patients with overlapping cardiovascular, kidney, and metabolic diseases, thereby improving outcomes and quality of life. 

Explore ISN CKM Initiative resources 

Interactive roadmap for clinicians 

At the heart of the CKM Initiative is an interactive roadmap designed to assist clinicians in managing patients with cardio-kidney-metabolic conditions. This user-friendly tool allows healthcare providers to navigate patient care based on key clinical parameters, facilitating personalized, evidence-based care. 

Key toolkits developed 

To support the roadmap, the ISN has developed several specialized toolkits: 

RAASi Optimization Toolkit: Focuses on the effective use of renin-angiotensin-aldosterone system inhibitors, addressing challenges like hyperkalemia and acute declines in eGFR. 

SGLT2i Optimization Toolkit: Provides guidance on the use of sodium-glucose cotransporter 2 inhibitors, emphasizing their role in managing cardio-kidney-metabolic conditions. 

CKM resources at the ISN Academy 

Watch the ISN Webinar: Current evidence and the future role of non-steroidal mineralocorticoid receptor antagonists in kidney and cardiovascular disease 

Watch the ISN Webinar: Understanding the cardiovascular effects of GLP-1 Receptor Agonists and implications in patients with CKD and cardiovascular disease 

Understanding the CKM Initiative 

Launched in 2022, the CKM Initiative is a collaborative effort between nephrologists and cardiologists to address the complex interplay between heart, kidney, and metabolic diseases. Recognizing the shared risk factors and pathophysiological mechanisms, the initiative focuses on optimizing therapies and improving patient care through comprehensive toolkits and resources. 

The Cardio-Kidney-Metabolic Initiative is supported by an unrestricted educational grant from Boehringer Ingelheim & Eli Lilly Company, and Novo Nordisk. 

 

 

Designed as an advocacy resource, the ISN fact sheet on rare kidney diseases (RKDs) was first launched in English at the 78th World Health Assembly. Now available in several languages, the ISN encourages all members and partners to leverage this tool in their advocacy, policymaking, and clinical engagement efforts. 

• Arabic 

• Chinese  

• French 

• Japanese 

• Spanish 

Access the translated fact sheets* 

The fact sheet highlights that “rare kidney diseases are lifelong conditions that require a broader understanding of their wider social and economic burden to drive investment and improve support for patients and caregivers across education, employment, and social services.” 

This resource is part of the ISN Rare Kidney Diseases Toolkit, which curates infographics, webinars, accredited curricula, and more to advance understanding, advocacy, and care for patients with rare kidney diseases.  

Explore the complete toolkit 

Explore ISN Academy resources on RKDs 

*These resources are supported by Novartis. 

The Rare Kidney Diseases Toolkit is supported by Otsuka.