Ajay Singh discusses the state of rare kidney disease research. Sarah Tolson highlights the concerns and challenges dialysis programs face under the 2025 ESRD PPS requirements. Dr. Ajay Singh and others pay tribute to Dr. Barry Brenner, a leading nephrologist who passed away in August 2024. Sarah Tolson shares what billing departments of dialysis programs need to know about the CMS final rule for the ESRD PPS. It is important to understand the challenges Medicare Advantage plans present for ESRD care. Dr. Ajay Singh discusses the reasons why medical students and residents are not choosing to pursue careers in nephrology. Sarah Tolson reviews the key financial implications of the CMS proposed rule for the ESRD Prospective Payment System. Ajay Singh pays tribute to the late nephrologist and researcher Nicolaos Madias, MD, of Tufts Medical Center. The four-pillar approach to treating diabetic kidney disease (DKD) has been endorsed by high-quality trials, such as FLOW. It is essential for nephrology practices and dialysis centers to have backup methods for processing claims. IgA nephropathy (IgAN) is on the cusp of a transformational change in its treatment. Medicare Advantage plans are posing significant operational and financial hurdles for dialysis programs. APRIL has emerged as a critical factor in the pathogenesis of IgAN and is the focus of several clinical development programs. The benefit-risk ratio and considerations about unmet need are worth considering. The choice of a billing solution, often made under the guise of cost savings, requires a thoughtful approach. The new base rate for CY 2024 is set at $271.02, which is a 2% increase from CY 2023. SGLT2i therapy is contraindicated in patients with type 1 diabetes mellitus (T1DM) who have CKD. The first part of the dialysis moonshot is to prevent the need for dialysis. When collections waver, a facility’s financial health teeters. Measuring eGFR and UACR is a key component of guideline-directed medical therapy for patients with CKD from type 2 diabetes.