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From 2019 to 2025, an ISN Sister Renal Centers (SRC) partnership strengthened nephrology care and education in Central Java, Indonesia. The collaboration connected the emerging center, Dr. Kariadi Hospital, Indonesia, with the supporting center, Austin Health in Melbourne, Australia, and worked closely with the . It was jointly supported by the ISN and the Australian and New Zealand Society of Nephrology.

Responding to gaps in kidney care

In a landscape where nephrology services had previously been concentrated in a few hospitals in Semarang, and many patients from rural districts faced long journeys for dialysis and delays in care, the partnership set out to strengthen kidney care across Central Java by expanding access, building workforce capacity, improving quality standards, fostering research, and engaging the community.

According to the liaison officer at Dr. Kariadi Hospital, Dwi Lestari Partiningrum, the SRC partnership has resulted in demonstrable improvements in renal pathology services, kidney transplant capacity, peritoneal dialysis, clinician training, and multidisciplinary collaboration. She comments, “The SRC Program exceeded our objectives, transforming patient care, advancing education, and research. These gains are sustainable and institutionally embedded. The partnership has transitioned from capacity building to capacity consolidation, positioning the center for continued growth and long-term impact in renal care.”

Strengthening renal pathology and kidney transplant capacity

One of the clearest examples of this progress is the development of renal pathology services at Dr. Kariadi Hospital, particularly for glomerulonephritis. SRC Program support enabled the hospital to expand its pool of pathologists with expertise in glomerulonephritis from two to six. Monthly multidisciplinary meetings with Austin Health specialists provided a structured forum for reviewing complex renal biopsy cases and supporting clearer diagnosis and treatment decisions. As a result, biopsy interpretation has become faster and more consistent, and local clinicians report greater confidence in their diagnoses and management decisions.

With support from Austin Health transplant specialists Bulang He and John Whitlam, Dr. Kariadi Hospital expanded its kidney transplant capacity through hands-on education and case discussions. This helped the hospital manage more diverse and complex transplant cases locally, including immunologically sensitized patients who previously would have been referred to Jakarta for treatment.

Expanding the kidney care workforce

Training and knowledge exchange were central to the partnership’s long-term impact. During the collaboration, two Dr. Kariadi nephrology fellows completed immersive observerships at Austin Health, gaining first-hand exposure to transplant care, kidney biopsy practice, dialysis services, multidisciplinary meetings, and structured teaching.

In Semarang, Austin Health nephrologists and pathologists contributed to lectures, ward rounds, workshops, webinars, and regional symposia, including the 2024 Semarang International Glomerulonephritis Symposium, which featured presentations by Austin Health’s head of nephrology, Peter Mount, and renal pathologist Benjamin Popp.

These activities reached hundreds of clinicians and trainees across Central Java, strengthened academic engagement, supported more than 10 research projects, and helped position Dr. Kariadi Hospital as a regional hub for nephrology care, education, and research. As a result, the kidney care workforce has expanded across Central Java, with the number of nephrologists more than doubling from 11 to 23, alongside growth in dialysis-trained internists, general practitioners, and renal nurses.

As services expanded into district hospitals, dialysis and outpatient kidney care became more accessible for patients outside Semarang, helping reduce the burden of long-distance travel. Community outreach activities also reached more than 1,000 people, helping raise awareness and detect chronic kidney disease risk factors earlier across the region.

Sustaining progress through continued collaboration

Looking ahead, a recently agreed Memorandum of Understanding between Dr. Kariadi Hospital and Austin Health provides a strong foundation for continued collaboration. Through nurse exchanges, nephrology trainee opportunities, and expanded joint activities, the partnership is set to continue advancing kidney care and education.

Dr. Partiningrum stated, “We are grateful for this SRC partnership. The program exemplifies the ISN’s mission to foster global collaborations that improve outcomes for people with kidney disease, while creating enduring professional and institutional links. It has delivered lasting improvements in clinical services and capability, education, and professional development in Central Java, Indonesia.”