An abrupt policy change in 2022 — allowing patients to choose between peritoneal dialysis or hemodialysis — created severe unintended consequences for the Thai health system. A multidisciplinary commission found that interacting factors in the system were overlooked and that future dialysis policies must integrate more-diverse evidence and stakeholder views, prioritizing care quality and ethics while balancing equity and sustainability.

This multicenter study demonstrates use of dried and capillary blood as a minimally invasive, scalable approach for Alzheimer’s biomarker testing in research, with potential as a widely scalable population-based research approach, especially in resource-limited settings.

Analyzing data of the Mexican Biobank project, a new study finds regional differences in clinically relevant genetic frequencies and presents MexVar, a publicly accessible resource designed to support ancestry-informed genetic testing.

MedHELM, an extensible evaluation framework including a new taxonomy for classifying medical tasks and a benchmark of many datasets across these categories, enables the evaluation of large language models on real-world clinical tasks.

In a phase 2 trial evaluating healthy donor fecal microbial transplantation plus either anti-PD-1 in patients with non-small cell lung cancer or anti-PD-1 and anti-CTLA-4 in patients with melanoma, encouraging efficacy was seen in both cohorts, with responses linked to significantly greater loss of baseline bacterial species.

In a double-blind, placebo-controlled phase 2 trial in patients with metastatic renal cell carcinoma treated with anti-PD-1 plus a VEGFR tyrosine kinase inhibitor, donor fecal microbial transplantation (FMT) from complete responders to immunotherapy did not significantly improve the primary endpoint of 12-month progression-free survival (PFS) but did significantly improve median PFS versus placebo FMT.

Five-year survival data and biomarker analysis of the PRADO extension cohort of the phase 2 OpACIN-neo trial, in which patients with high-risk stage III melanoma received neoadjuvant ipilimumab and nivolumab and underwent pathologic response-directed surgery and adjuvant therapy, show 71% event-free survival and 88% overall survival, with tumor mutational burden, IFNγ signature and PD-L1 expression associated with favorable outcomes.

In a phase 1 trial testing healthy donor fecal microbial transplantation with immune checkpoint blockade in patients with previously untreated renal cell carcinoma, treatment was safe with an encouraging response signal and microbiome analyses, suggesting specific donor taxa associations with toxicity.

Transcriptomic and clinical data analyses from multiple cohorts of patients with cancer receiving immunotherapy find that PD-1 blockade potentiates tumor-specific IgG1 plasma cell responses that complement cellular immunity and contribute to clinical benefit.

Analyzing data of the Mexican Biobank project, a new study finds regional differences in clinically relevant genetic frequencies and presents MexVar, a publicly accessible resource designed to support ancestry-informed genetic testing.

Women in medicine face persistent structural and cultural barriers that disproportionately impede career advancement. Here we describe how professional medical associations can advance academic, scholarly and leadership development through inclusive strategies and practical frameworks designed to address both systemic and individual challenges.

We propose straightforward principles to foster an evaluation-forward operating system that can transform the adoption of clinical artificial intelligence from a leap of faith into a stepwise, trust-building process.

The first Nature Portfolio Commission Report outlines paths to sustainable dialysis policies, robust evidence-to-policy translation and south–south collaboration.

Rising demand for dialysis poses a central challenge to universal health coverage systems: not just whether to expand access, but how to sustain equitable, high-quality kidney failure care. In this Comment, I argue that long-term viability depends on system architecture, rather than modality choice alone.