{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:29:50Z","timestamp":1786480190218,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Nepal has made significant strides in nephrology, progressing from no dialysis services to offering comprehensive kidney care, including dialysis and transplantation. The journey began in the 1980s with the establishment of the first nephrology unit at Bir Hospital and has since grown to encompass over 60 dialysis centers and multiple transplant facilities. Government initiatives, such as financial subsidies and health insurance schemes, have increased accessibility, yet disparities persist due to workforce shortages, uneven infrastructure distribution, and inconsistent quality control in dialysis services. Predialysis care remains underdeveloped, and challenges in adopting peritoneal dialysis persist due to socioeconomic and logistical barriers. The kidney transplant program, primarily reliant on living donors, has shown steady growth. Critical care nephrology and interventional services are gradually emerging. To advance, addressing workforce shortages, improving care quality, and expanding equitable access through strategic investments and global partnerships are essential.<\/jats:p>","DOI":"10.34067\/kid.0000000991","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T17:00:10Z","timestamp":1756918810000},"page":"199-204","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Nephrology in Nepal"],"prefix":"10.34067","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8335-4107","authenticated-orcid":false,"given":"Deepak","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Nephrology, Dhulikhel Hospital, Kathmandu University School of Medical Science, Dhulikhel, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3304-1536","authenticated-orcid":false,"given":"Taranath","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medical sciences, Kathmandu University, Bharatpur, Chitwan, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8097-6470","authenticated-orcid":false,"given":"Jie","family":"Tang","sequence":"additional","affiliation":[{"name":"Division of Kidney Diseases and Hypertension, Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"issue":"8","key":"B1-20260129","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1177\/02690942241270566","article-title":"Navigating Nepal\u2019s development trajectory: the road to graduation from the LDC status and beyond","volume":"38","author":"Gautam","year":"2023","journal-title":"Local Econ."},{"issue":"5","key":"B3-20260129","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/nep.12046","article-title":"Renal transplantation in Nepal: beginning of a new era","volume":"18","author":"Shah","year":"2013","journal-title":"Nephrology (Carlton)."},{"issue":"7","key":"B4-20260129","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.34067\/KID.0001672022","article-title":"Global dialysis perspective: Nepal","volume":"3","author":"Sharma","year":"2022","journal-title":"Kidney360."},{"issue":"1","key":"B5-20260129","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1093\/ckj\/sfv109","article-title":"Chronic kidney disease hotspots in developing countries in South Asia","volume":"9","author":"Abraham","year":"2016","journal-title":"Clin Kidney J."},{"issue":"3","key":"B6-20260129","doi-asserted-by":"crossref","first-page":"e057509","DOI":"10.1136\/bmjopen-2021-057509","article-title":"Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study","volume":"12","author":"Poudyal","year":"2022","journal-title":"BMJ Open."},{"issue":"5","key":"B8-20260129","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1007\/s40620-024-02200-6","article-title":"Tackling chronic kidney disease in Nepal: from evidence to action","volume":"38","author":"Mishra","year":"2025","journal-title":"J Nephrol."},{"issue":"2","key":"B9-20260129","first-page":"153","article-title":"Implications of dual practice among health workers: a systematic review","volume":"46","author":"Moghri","year":"2017","journal-title":"Iran J Public Health."},{"issue":"8","key":"B10-20260129","doi-asserted-by":"crossref","first-page":"e0309203","DOI":"10.1371\/journal.pone.0309203","article-title":"Exploring lifestyles, work environment and health care experience of Nepalese returnee labour migrants diagnosed with kidney-related problems","volume":"19","author":"Regmi","year":"2024","journal-title":"PLoS One."},{"issue":"2","key":"B11-20260129","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/ndt\/gfw346","article-title":"Chronic interstitial nephritis in agricultural communities: a worldwide epidemic with social, occupational and environmental determinants","volume":"32","author":"Jayasumana","year":"2017","journal-title":"Nephrol Dial Transplant."},{"key":"B12-20260129","doi-asserted-by":"crossref","first-page":"4768540","DOI":"10.1155\/2022\/4768540","article-title":"Impact of early versus late referral to nephrologists on outcomes of chronic kidney disease patients in Northern India","volume":"2022","author":"Dhanorkar","year":"2022","journal-title":"Int J Nephrol."},{"issue":"1","key":"B13-20260129","doi-asserted-by":"crossref","first-page":"403","DOI":"10.3126\/nmj.v3i2.34111","article-title":"Vascular access use among hemodialysis patients and competency of nurses at National Kidney Centre, Nepal","volume":"4","author":"Basnet","year":"2021","journal-title":"Nepalese Med J."},{"key":"B14-20260129","first-page":"104386","article-title":"Kidney transplantation from brain-dead donors in Nepal: report of first six cases","volume":"81","author":"Shrestha","year":"2022","journal-title":"Ann Med Surg (Lond)."},{"issue":"1","key":"B17-20260129","doi-asserted-by":"crossref","first-page":"102","DOI":"10.23876\/j.krcp.23.039","article-title":"Nephrology consultation improves the clinical outcomes of patients with acute kidney injury","volume":"44","author":"Rhee","year":"2025","journal-title":"Kidney Res Clin Pract."},{"issue":"1","key":"B18-20260129","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.3126\/jpn.v8i1.19443","article-title":"Histopathological audit of renal biopsy in Nepalese children: two center experience","volume":"8","author":"Shrestha","year":"2018","journal-title":"J Pathol Nepal."},{"issue":"3","key":"B19-20260129","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3126\/jnps.v34i3.11162","article-title":"Spectrum of biopsy proven glomerular disease in children at Kanti children\u2019s hospital","volume":"34","author":"Khatun","year":"2015","journal-title":"J Nepal Paediatric Soc."},{"issue":"10","key":"B20-20260129","doi-asserted-by":"crossref","first-page":"e0276172","DOI":"10.1371\/journal.pone.0276172","article-title":"Clinical and histopathological study of renal biopsy in Nepalese children: a single center experience","volume":"17","author":"Amatya","year":"2022","journal-title":"PLoS One."},{"issue":"1","key":"B21-20260129","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12882-025-04073-8","article-title":"A narrative review of acute post-streptococcal glomerulonephritis in Nepali children","volume":"26","author":"Dhakal","year":"2025","journal-title":"BMC Nephrol."},{"issue":"8","key":"B22-20260129","doi-asserted-by":"crossref","first-page":"e13588","DOI":"10.1111\/petr.13588","article-title":"Pediatric kidney transplantation in Nepal","volume":"23","author":"Kafle","year":"2019","journal-title":"Pediatr Transplant."}],"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000000991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:56:29Z","timestamp":1786478189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000000991"}},"subtitle":["How it Started and Where We Are"],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0000000991","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}