Volume 19 Issue 6, June 2023

Understanding of the barriers to adequate health care experienced by sexual and gender minority (SGM) people cannot be achieved in the absence of robust and appropriate data. The inclusion of SGM populations in health research and the collection of sexual orientation and gender identity data in research and routine clinical practice is therefore essential to understanding the unique needs of these populations and addressing inequities in health outcomes.

Specific policies embedded in organ and tissue donation and transplantation systems discriminate against sexual orientation- and gender identity-diverse populations, restricting or excluding the use of donated organs and tissues. Revision of these policies is needed to promote equity and increase the supply of high-quality organs and tissues for those who need them.

Transgender persons can face a number of barriers in accessing primary and specialist care that is equitable, inclusive and appropriate for their needs. In this Viewpoint, commissioned to recognize Pride, five researchers with expertise across different disciplines, including nephrology, endocrinology, public health, psychology and sociology, provide their perspectives on key considerations that are required to achieve optimal primary and nephrology care for transgender individuals, including barriers to care and how these might be overcome to ensure that the provision of care is inclusive and safe.

In this Review, the authors describe the roles of lysosomes in cellular clearance, autophagy, cell signalling, nutrient sensing and metabolic adaptation. They also discuss lysosome abnormalities in metabolic and autoimmune diseases and potential lysosome-targeting therapeutic strategies.

In this Review, the authors discuss the molecular and cellular mechanisms by which pathogenic variants in various genes cause distal renal tubular acidosis with renal and extrarenal manifestations. They also discuss acquired and incomplete forms of distal renal tubular acidosis.

Sepsis-associated acute kidney injury (SA-AKI) is linked with poor outcomes in critically ill patients. This Consensus Statement from the Acute Disease Quality Initiative discusses the definition, epidemiology and pathophysiology of SA-AKI, fluid, resuscitation and extracorporeal therapies, and the role of biomarkers in risk stratification and diagnosis.