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The American Society of Nephrology, the European Renal Association–European Dialysis and Transplant Association and the International Society of Nephrology Joint Working Group on Ethical Issues in Nephrology have identified ten broad areas of ethical concern as priority challenges that require collaborative action. Here, we describe these challenges — equity in access to kidney failure care, avoiding futile dialysis, reducing dialysis costs, shared decision-making in kidney failure care, living donor risk evaluation and decision-making, priority setting in kidney disease prevention and care, the ethical implications of genetic kidney diseases, responsible advocacy for kidney health and management of conflicts of interest — with the aim of highlighting the need for ethical analysis of specific issues, as well as for the development of tools and training to support clinicians who treat patients with kidney disease in practising ethically and contributing to ethical policy-making.Here, the ASN-ERA-EDTA-ISN Joint Working Group on Ethical Issues in Nephrology highlights ten areas of ethical concern as priority challenges that require collaborative action and discusses the need for development of ethical training and guidance tools to manage these issues.

What could you do to support medical care in developing countries? This question should be compelling to many physicians in developed regions of the world, particularly those working in nephrology--a subspecialty often associated with expensive and technologically advanced therapies.

Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations.

The elevated prevalence of CKD of unspecified cause that has been reported in male farmers in various developing countries confirms this relationship. 2 Indeed, in Nicaragua, increased CKD rates in male farmers aged <60 years were found to be associated with pesticide exposure, dehydration, alcohol consumption and exposure to heavy metals. 3 Costa Rica has reported a higher incidence of chronic renal disease among young sugarcane workers, with clinical and histological findings of chronic interstitial nephritis. 4 In El Salvador, a high prevalence of CKD (17%) was found among male farmers exposed to toxic pollutants. 5 Studies in Sri Lanka have found an association between pesticide poisoning and pollutants, and repeated episodes of acute renal failure and CKD, respectively. 6 In India and Pakistan, a large percentage of CKD cases are of undetermined aetiology and environmental factors have been postulated for causation of the disease. 7 The association of poverty and disease could explain the increased burden of CKD in these populations.

The purpose of this manuscript is to describe a collaborative research initiative to explore the role of hydration in kidney health. Our understanding of the effects of hydration in health and disease is surprisingly limited, particularly when we consider the vital role of hydration in basic human physiology. Recent initiatives and research outcomes have challenged the global medical community to expand our knowledge about hydration, including the differences between water, sugared beverages and other consumables. Identification of the potential mechanisms contributing to the benefits of hydration has stimulated the global nephrology community to advance research regarding hydration for kidney health. Hydration and kidney health has been a focus of research for several research centers with a rapidly expanding world literature and knowledge. The International Society of Nephrology has collaborated with Danone Nutricia Research to promote development of kidney research initiatives, which focus on the role of hydration in kidney health and the global translation of this new information. This initiative supports the use of existing data in different regions and countries to expand dialogue among experts in the field of hydration and health, and to increase scientific interaction and productivity with the ultimate goal of improving kidney health.