Ethical Perspectives in Renal Genetic Testing and Counseling

This report examines ethical considerations surrounding genetic testing in nephrology. More than 14% of the U.S. population lives with CKD, including approximately 800,000 individuals receiving treatment for end-stage kidney disease, and an estimated 20% of CKD cases have a genetic etiology. As genetic testing becomes integrated into routine care, careful evaluation of its risks and benefits is essential. Using the Georgetown principles-autonomy, beneficence, nonmaleficence, and justice-as a framework, we analyze contemporary ethical challenges in renal genetics. We emphasize the importance of shared decision-making, culturally and linguistically appropriate risk communication, and access to genetic counseling. Finally, we offer practical recommendations to strengthen ethical implementation and advance equitable integration of genomic medicine in nephrology.