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To some extent, the higher CKD burden represents the price of success in prolonging longevity by decreasing other causes of death. Now is the time to act to minimize the negative impact of CKD on aging societies through primary prevention and early diagnosis and treatment of CKD. Action aimed at maintaining kidney health and delaying biological kidney aging will contribute to healthy aging, as the kidneys have gerosuppressor functions and CKD has the highest negative impact on body aging among chronic non-communicable diseases. This action should be part of a move towards novel holistic approaches to healthy longevity represented by concepts such as cardiovascular–kidney–metabolic health, geromedicine, gerosuppressors and organ rejuvenation. We discuss a conceptual framework for the present and future of kidney aging and kidney health in the elderly, emphasizing opportunities for intervention that underlie the Japanese Society of Nephrology and European Renal Association call to action on Achieving Kidney Health in Aging/Aged Societies. Keywords: aging, chronic kidney disease, gerosuppression, kidney aging, kidney replacement therapy Author: Ortiz Alberto, Kramer Anneke, Rychlík Ivan, Nangaku Masaomi, Yanagita Motoko, Jager Kitty J., Caskey Fergus J., Stel Vianda S., Kashihara Naoki, Kuragano Takahiro, Suzuki Yusuke, Takemoto Yoshiaki, Yokoi Hideki, Palladino Giuseppe, Fliser Danilo, Torra Roser, Wanner Christoph Creator: OUP Producer: Acrobat Distiller 10.0.0 (Windows) CreationDate: Tue Jul 15 18:08:27 2025 CEST ModDate: Tue Jul 15 18:09:07 2025 CEST Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 782.362 pts Page rot: 0 File size: 1398633 bytes Optimized: yes PDF version: 1.3 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CFLBCJ+CaeciliaLTStd-Heavy Type 1C WinAnsi yes yes no 1948 0 CFKMHF+CaeciliaLTStd-Roman Type 1C Custom yes yes yes 1951 0 CFLALK+CaeciliaLTStd-Light Type 1C Custom yes yes yes 1956 0 CFKFBD+CaeciliaLTStd-Bold Type 1C WinAnsi yes yes no 1961 0 CFKMHE+dummy-space Type 1C WinAnsi yes yes no 1964 0 CFLBFI+RMTMI Type 1C Custom yes yes yes 1967 0 CFKMGE+CaeciliaLTStd-Italic Type 1C WinAnsi yes yes no 1972 0 CFLBLH+MTSY Type 1C Custom yes yes yes 386 0 CFLECK+ArialMT Type 1C MacRoman yes yes no 392 0 CFLCLC+CaeciliaLTStd-LightItalic Type 1C WinAnsi yes yes no 395 0 CFLECJ+Arial-BoldMT Type 1C MacRoman yes yes no 398 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-06-05 04:52:53 CEST RepresentationInformation: 328504.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-06-04 09:24:35 CEST Size: 1398633 Format: PDF Version: 1.3 Status: Well-Formed, but not valid SignatureMatches: PDF-hul ErrorMessage: Invalid indirect destination - 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referenced object 'bib60-b' cannot be found ID: PDF-HUL-122 Offset: 1212563 ErrorMessage: edu.harvard.hul.ois.jhove.module.pdf.PdfInvalidException: Invalid indirect destination - referenced object 'bib30-b' cannot be found ID: PDF-HUL-122 Offset: 1212563 ErrorMessage: edu.harvard.hul.ois.jhove.module.pdf.PdfInvalidException: Invalid indirect destination - referenced object 'bib6-b' cannot be found ID: PDF-HUL-122 Offset: 1212563 MIMEtype: application/pdf Profile: Linearized PDF, Tagged PDF PDFMetadata: Objects: 2060 FreeObjects: 1 IncrementalUpdates: 1 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: false CenterWindow: false DisplayDocTitle: true NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: OneColumn PageMode: UseOutlines Language: English Outlines: Item: Title: KIDNEY DISEASE BURDEN IN AN AGING WORLD Destination: section*.2 Item: Title: BIOLOGICAL AGING AS A TREATABLE CONDITION: KIDNEYS AS GEROSUPPRESSORS Destination: section*.4 Item: Title: KIDNEY CARE IN AN AGING SOCIETY Destination: section*.6 Children: Item: Title: Maintaining kidney health: biological kidney aging as a preventable condition Destination: section*.8 Item: Title: CKD management in the elderly Destination: section*.10 Item: Title: Kidney failure management in the elderly Destination: section*.12 Item: Title: Kidney rejuvenation Destination: section*.14 Item: Title: CALL TO ACTION Destination: section*.16 Children: Item: Title: Box JSN and ERA call to action: Achieving Kidney Health in Aging/Aged Societies Destination: section*.18 Item: Title: SUPPLEMENTARY DATA Destination: section*.20 Item: Title: ACKNOWLEDGEMENTS Destination: section*.22 Item: Title: FUNDING Destination: section*.24 Item: Title: AUTHORS’ CONTRIBUTIONS Destination: section*.26 Item: Title: DATA AVAILABILITY STATEMENT Destination: section*.28 Item: Title: CONFLICT OF INTEREST STATEMENT Destination: section*.30 Item: Title: REFERENCES Destination: section*.32 Info: Title: Maintaining kidney health in aging societies: a JSN and ERA call to action Author: Ortiz Alberto, Kramer Anneke, Rychlík Ivan, Nangaku Masaomi, Yanagita Motoko, Jager Kitty J., Caskey Fergus J., Stel Vianda S., Kashihara Naoki, Kuragano Takahiro, Suzuki Yusuke, Takemoto Yoshiaki, Yokoi Hideki, Palladino Giuseppe, Fliser Danilo, Torra Roser, Wanner Christoph Subject: DOI: 10.1093/ndt/gfaf068 Nephrology Dialysis Transplantation, 40, 8, 10-04-2025. Abstract: Chronic kidney disease (CKD) is the fastest growing cause of death, expected to become the fifth global cause of death and the third in some countries with long life expectancy, such as Japan and Spain, by 2050. This reflects societal aging, as advancing kidney age is the main risk factor for CKD. The forecasted 140% increase in the death rate from CKD by 2050 is reduced to 33% when adjusted for age. The increasing mortality burden is paralleled by higher personal, healthcare, socio-economic and environmental burdens and the need for kidney replacement therapy to treat kidney failure. To some extent, the higher CKD burden represents the price of success in prolonging longevity by decreasing other causes of death. Now is the time to act to minimize the negative impact of CKD on aging societies through primary prevention and early diagnosis and treatment of CKD. Action aimed at maintaining kidney health and delaying biological kidney aging will contribute to healthy aging, as the kidneys have gerosuppressor functions and CKD has the highest negative impact on body aging among chronic non-communicable diseases. This action should be part of a move towards novel holistic approaches to healthy longevity represented by concepts such as cardiovascular–kidney–metabolic health, geromedicine, gerosuppressors and organ rejuvenation. We discuss a conceptual framework for the present and future of kidney aging and kidney health in the elderly, emphasizing opportunities for intervention that underlie the Japanese Society of Nephrology and European Renal Association call to action on Achieving Kidney Health in Aging/Aged Societies. Keywords: aging, chronic kidney disease, gerosuppression, kidney aging, kidney replacement therapy Creator: OUP Producer: Acrobat Distiller 10.0.0 (Windows) CreationDate: Tue Jul 15 18:38:27 CEST 2025 ModDate: Tue Jul 15 18:39:07 CEST 2025 ID: 0xb565e82358e042f6d63dd0a60d6fb967, 0x16fa48e01ff845d72d98c586448b933a Filters: FilterPipeline: FlateDecode FilterPipeline: DCTDecode Images: Image: NisoImageMetadata: FormatName: image/png ImageWidth: 714 ImageHeight: 243 BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Image: NisoImageMetadata: FormatName: image/png ImageWidth: 66 ImageHeight: 24 BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Image: NisoImageMetadata: FormatName: image/png ImageWidth: 338 ImageHeight: 11 BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 193 ImageHeight: 629 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Image: 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10.1093/ndt/gfaf068 1460-2385 Nephrology Dialysis Transplantation journal 40 10.1093/ndt/gfaf068 https://doi.org/10.1093/ndt/gfaf068 © The Author(s) 2025. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com All Rights Reserved application/pdf doi:10.1093/ndt/gfaf068 © The Author(s) 2025. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Ortiz Alberto Kramer Anneke Rychlík Ivan Nangaku Masaomi Yanagita Motoko Jager Kitty J. Caskey Fergus J. Stel Vianda S. Kashihara Naoki Kuragano Takahiro Suzuki Yusuke Takemoto Yoshiaki Yokoi Hideki Palladino Giuseppe Fliser Danilo Torra Roser Wanner Christoph Oxford University Press DOI: 10.1093/ndt/gfaf068 Nephrology Dialysis Transplantation, 40, 8, 10-04-2025. Abstract: Chronic kidney disease (CKD) is the fastest growing cause of death, expected to become the fifth global cause of death and the third in some countries with long life expectancy, such as Japan and Spain, by 2050. This reflects societal aging, as advancing kidney age is the main risk factor for CKD. The forecasted 140% increase in the death rate from CKD by 2050 is reduced to 33% when adjusted for age. The increasing mortality burden is paralleled by higher personal, healthcare, socio-economic and environmental burdens and the need for kidney replacement therapy to treat kidney failure. To some extent, the higher CKD burden represents the price of success in prolonging longevity by decreasing other causes of death. Now is the time to act to minimize the negative impact of CKD on aging societies through primary prevention and early diagnosis and treatment of CKD. Action aimed at maintaining kidney health and delaying biological kidney aging will contribute to healthy aging, as the kidneys have gerosuppressor functions and CKD has the highest negative impact on body aging among chronic non-communicable diseases. This action should be part of a move towards novel holistic approaches to healthy longevity represented by concepts such as cardiovascular–kidney–metabolic health, geromedicine, gerosuppressors and organ rejuvenation. We discuss a conceptual framework for the present and future of kidney aging and kidney health in the elderly, emphasizing opportunities for intervention that underlie the Japanese Society of Nephrology and European Renal Association call to action on Achieving Kidney Health in Aging/Aged Societies. aging chronic kidney disease gerosuppression kidney aging kidney replacement therapy Maintaining kidney health in aging societies: a JSN and ERA call to action Ortiz Alberto, Kramer Anneke, Rychlík Ivan, Nangaku Masaomi, Yanagita Motoko, Jager Kitty J., Caskey Fergus J., Stel Vianda S., Kashihara Naoki, Kuragano Takahiro, Suzuki Yusuke, Takemoto Yoshiaki, Yokoi Hideki, Palladino Giuseppe, Fliser Danilo, Torra Roser, Wanner Christoph uuid:75a1fe36-f948-3cff-afd2-371272938067 uuid:4e6a2eb9-5503-4200-a95b-3c645a99e2a7 True Pages: Page: Label: 1498 Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 425, 729, 548, 739 Annotation: Subtype: Link Rect: 92, 627, 104, 638 Annotation: Subtype: 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