Is dialysis nephrology’s greatest achievement or its original sin? In this Kidney Commute: Pit Stop episode, host Dr. Osama El Shamy, welcomes Dr. Andrew Cohen, to discuss a provocative question that challenges how the field of nephrology has evolved. Drawing from Dr. Cohen’s recent AJKD publication, the conversation explores key historical milestones, including early innovations, the 1972 Medicare amendment, and the rise of corporatized dialysis care. Together, they examine how these forces have shaped trainee perceptions, workforce recruitment, and the identity of nephrology today. The episode concludes with a forward-looking discussion on how the field can refocus priorities, embrace innovation, and chart a more balanced path beyond dialysis-centered care.

AJKD Article: https://www.ajkd.org/article/S0272-6386(25)00711-5/abstract