The evolving field of nephrology: what comes next? A report from the European Renal Association Scientific Advisory Board

Abstract

The field of nephrology is rapidly expanding and evolving with advancements in the areas of diagnostics including biomarkers, molecular genetics and imaging modalities, and therapeutics. As acute kidney injury affects a substantial proportion of hospitalized patients with considerable morbidity and mortality risk and chronic kidney disease is among the leading causes of morbidity and mortality globally, the advancements in the field of nephrology are worth focusing on and highlighting. Novel biomarkers along with better imaging modalities, including functional tools such as positron emission tomography and contrast-enhanced ultrasound, may enable earlier diagnosis of kidney injury and potentially reverse injury state before the establishment of an irreversible state of injury. Moreover, there are multiple ongoing clinical trials evaluating novel therapeutic approaches, advancements in kidney replacement therapies or targeted approaches against kidney transplantation including xenotransplantation and plasma cell-directed therapies. In addition, artificial intelligence may become a game changer in nephrology, providing improved diagnostic and therapeutic alternatives. However, the limitations of current state of knowledge in those novel modalities should be adequately acknowledged and addressed. In this narrative review, our aim is to evaluate the current state of advancements in the field of nephrology in terms of diagnostics, imaging modalities, biomarkers, and therapeutics along with providing potential future perspectives.