ISN Journal summaries on parathyroid hormone in CKD-related osteoporosis and kidney care fragility in Nepal
Kidney International®
Uremia and parathyroid hormone have distinct effects on bone protein and gene expression
People with chronic kidney disease (CKD) remain at high risk of fractures despite treatment aimed at maintaining parathyroid hormone at acceptable levels.
This study examined the distinct effects of uremia and parathyroid hormone on bone in patients on hemodialysis and controls.
The authors found that CKD drives inflammation, cell death, and bone loss, while elevated parathyroid hormone has both protective and harmful effects, suggesting future approaches may need to improve bone quality without increasing bone damage.
Kidney International Reports®
This editorial examines how Nepal’s nephrology workforce and kidney care system were affected by the 2025 Gen Z protests, which exposed existing weaknesses in access, staffing, dialysis delivery, and system resilience.
Based on a nationwie survey of practicing nephrologists, it found extreme workforce concentration in the Bagmati Province and urban areas, overwhelming reliance on hemodialysis, major barriers to peritoneal dialysis, declining procedural capacity, and signs of burnout.
The authors argue that the protests did not create these problems but intensified them, and they call for workforce-centered reforms to strengthen kidney care access, resilience, and sustainability in Nepal.
