Launching Kidney360

In 2019, I was honored to be selected by the American Society of Nephrology (ASN) as the inaugural Editor-in-Chief of Kidney360, an open access, online only nephrology journal. My initial reaction was a combination of excitement at the tremendous opportunity to shape a new nephrology journal, as well as great apprehension about the challenges of carving a niche in a crowded field of nephrology journals. After all, I would be responsible for the success of a new medical journal with no track record, no citations in PubMed, and no impact factor to induce authors to submit to this unknown entity. Would people want to read the content featured in this journal? Would clinical nephrologists and scientists be willing to submit their original manuscripts to it? Would busy and successful clinicians and scientists be willing to serve on the editorial team? The ASN leadership was highly committed to the success of Kidney360. They provided financial compensation for me, two Deputy Editors, and 13 Associate Editors, as well as a full-time Managing Editor. I was gratified that multiple international experts in nephrology were willing to take a chance and devote their time and effort to ensure the success of this nascent journal. The ASN approved my selections for the editorial team in short order, and our initial face-to-face meeting took place at the new ASN headquarters in Washington, DC, in October 2019, 3 months ahead of publication of our first issue in January 2020. Shortly after launching Kidney360, the world was faced with the global coronavirus disease 2019 (COVID-19) pandemic. We had been planning to have face-to-face meetings with individuals with oral or poster presentations at scientific meetings and convince them to submit their research papers to Kidney360. Instead, all face-to-face meetings were abruptly canceled, and communication was restricted to seemingly endless and unsatisfying Zoom calls. Appeals for submissions were limited to phone calls, emails, or video conferences. The COVID-19 pandemic imposed enormous challenges to nephrologists trying to provide excellent care for patients with ESKD in the outpatient arena and the high volume of hospitalized patients with AKI, all while grappling with the daunting infection control constraints. Kidney360 was able to contribute to the education of nephrologists by publishing timely perspectives on the nuts and bolts of providing dialysis care during the pandemic, as well as original manuscripts describing novel insights about COVID-19. To differentiate Kidney360 from other nephrology journals, we launched several unique features. The first was a Global Perspectives in Nephrology series, in which clinicians from countries across the globe discussed the unique clinical and financial challenges and solutions related to the care of chronic dialysis patients, kidney transplant patients, and those with acute kidney failure. It was enlightening to understand both the commonalities and unique aspects of kidney care in different nations, ranging from high-income countries in which dialysis was guaranteed to all who need it to low-income countries in which dialysis was severely rationed. We have also published perspectives by nephrologists from countries which struggled to provide dialysis amid war or economic upheaval. To date, we have featured Global Perspectives from nearly 60 countries (Table 1). Table 1 - Global perspectives in Kidney360: dialysis, transplantation, and AKI Argentina Egypt Italy Nicaragua Sweden Australia Ethiopia Jamaica Nigeria Switzerland Bangladesh Fiji Japan North Macedonia Syria Bolivia France Kenya Peru Tanzania Bosnia Georgia Korea Romania Thailand Brazil Ghana Kuwait Saudi Arabia Turkey Brunei Guatemala Lebanon Senegal Uganda Canada Haiti Malaysia Singapore Ukraine Chile Iceland Maldives Somaliland United Kingdom China India Mauritius South Africa United States Congo Ireland Mexico Spain Vietnam Ecuador Israel Nepal Sri Lanka A second feature was the Debates in Nephrology. There are numerous unsettled issues in nephrology regarding the benefit of diagnostic tests or therapeutic regimens for different kidney diseases. In the absence of definitive randomized controlled trials, nephrologists struggle to make informed decisions in the face of a bewildering array of observational studies, which are frequently contradictory. Each debate asks a single medical question. The PRO and CON positions are presented, and they are complemented by a moderator summary that provides a balanced and nuanced answer to the question. To date, we have published over 40 debates. A third feature was Clinical Images in Nephrology and Dialysis. Authors are encouraged to highlight rare kidney conditions or common conditions with an unusual manifestation. The images may include a striking clinical finding, an unusual radiologic image, or a pathology slide. They are accompanied by a brief description of the patient's clinical presentation. Initially, we present just the images and a one-sentence description along with questions about the case on the Kidney360 website, and readers are encouraged to make the diagnosis. Subsequently, the questions are answered with a discussion about the diagnosis. In addition, the entire case, along with the diagnosis and a brief bibliography, is published in each issue. We average two to three Clinical Images in each issue and to date have published over 150 cases. Nearing the completion of my last year as Editor-in-Chief of Kidney360, I am proud of what we have accomplished during the past 6 years (72 monthly issues). We now receive about 1000 clinical and basic science manuscripts annually. Our acceptance rate for original manuscripts has decreased from 40% in 2020 to 13% in 2025. Our contents are indexed in PubMed. We have an increasing impact factor. A typical monthly issue comprises approximately 25 articles, including 12 original manuscripts, as well as research letters, reviews, perspectives, editorials, Global Perspectives, Debates, and Clinical Images. Until 2024, each of the three ASN scientific journals (JASN, CJASN, and Kidney360) operated largely autonomously. For the past 2 years, under the leadership of Rajnish Mehrotra, the senior editor of the ASN Portfolio, the three journals have forged a closer relationship, while still maintaining editorial independence. The changes have included forming a single editorial board, a single statistical review team, a single visual abstract team, standard formats for submitted manuscripts, a common policy on data sharing, and a streamlined process for transfer of manuscripts among the three journals. This new structure improves the experience of authors. Publication of a medical journal is truly a team effort. I am grateful to the outstanding members of our editorial team. Our two deputy editors, Luis Juncos and Mark Perazella, have worked tirelessly with me since day one, brainstorming about new ideas, providing sage counsel, and insisting on high standards of scientific rigor. Luis solicited and shepherded the reviews of the growing number of basic science papers submitted to our journal. Mark was the driving force behind the Debates and Clinical Images features. A highly committed cadre of Associate Editors have managed the reviews of numerous original and invited manuscripts: Nisha Bansal, Kerri Cavanaugh, Arlene Chapman, Steven Coca, Deidra Crews, Steven Crowley, Neera Dahl, Arjang Djamali, Jennifer Flythe, Leslie Gewin, John Imig, Reiko Inagi, Shuta Ishibe, Timmy Lee, Ruisheng Liu, Mariana Murea, Samir Parikh, Michael Romero, Prabhleen Singh, Tammy Sirich, and Amanda Vinson. Our Junior Associate Editors, Abinet Aklilu, Joyita Bharati, Molly Fisher, Benjamin Griffin, Liam Martin, Veronica Miguel Herranz, Goni Katz-Greenberg, Monica Ng, Denisha Spires, and Miguel Vieira have injected a large dose of youth, enthusiasm and new ideas. Our Editorial Board members serve as ambassadors for Kidney360 at their institution and provide a substantial share of reviews of submitted manuscripts. Managing Editors are the unsung heroes of medical journals. They expertly manage numerous communications with authors, reviewers, and editors and make the monthly issue magically appear in an organized and esthetically pleasing format. In doing their jobs, they allow the rest of the editorial team to focus exclusively on the science. We have been extremely fortunate to have two outstanding Editorial Managers, Virginia Ramsey and Kimberlyn Stuart, with expert oversight by Shari Leventhal. Finally, I am grateful to my wife, Amy, for her unflagging support of my career, and more recently, of the endless demands of being an Editor-in-Chief. I am turning over the editorship position to Charuhas Thakar, with complete confidence that he will steer Kidney360 to even greater heights during his tenure.

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