Large language models in nephrology: applications and challenges in chronic kidney disease management

Large language models (LLMs) represent a transformative advance in artificial intelligence, with growing potential to impact chronic kidney disease (CKD) management. CKD is a complex, highly prevalent condition requiring multifaceted care and substantial patient engagement. Recent developments in LLMs-including conversational AI, multimodal integration, and autonomous agents-offer novel opportunities to enhance patient education, streamline clinical documentation, and support decision-making across nephrology practice. Early reports suggest that LLMs can improve health literacy, facilitate adherence to complex treatment regimens, and reduce administrative burdens for clinicians. However, the rapid deployment of these technologies raises important challenges, including patient privacy, data security, model accuracy, algorithmic bias, and ethical accountability. Moreover, real-world evidence supporting the safety and effectiveness of LLMs in nephrology remains limited. Addressing these challenges will require rigorous validation, robust regulatory frameworks, and ongoing collaboration between clinicians, AI developers, and patients. As LLMs continue to evolve, future efforts should focus on the development of nephrology-specific models, prospective clinical trials, and strategies to ensure equitable and transparent implementation. If appropriately integrated, LLMs have the potential to reshape the landscape of CKD care and education, improving outcomes for patients and supporting the nephrology workforce in an era of increasing complexity.