Coordinated clinical trial networks in nephrology: strengthening research infrastructure and improving trial delivery.

Chronic kidney disease (CKD) affects ∼10% of the global population and is a leading cause of morbidity and mortality. Although therapeutic options in nephrology are rapidly expanding, the capacity to conduct large-scale clinical trials in Europe is increasingly constrained by fragmented infrastructure, complex administrative processes, and unequal access to trial participation. Coordinated clinical trial networks have emerged as a strategy to address these challenges. By enabling central feasibility assessment, harmonised contracting through pre-existing master agreements, and systematic outreach to all participating sites, such networks can accelerate trial start-up, improve recruitment, and enhance inclusivity. Nephrology Research Organisation The Netherlands (NEFRO-NL) represents a recent example of this approach. By linking hospitals nationwide, this trial network facilitates multicentre collaboration, supports investigator-initiated research, and promotes more efficient use of patient populations. While long-term impact on trial performance remains to be established, early experience suggests that coordinated trial networks can enhance efficiency and broaden participation in nephrology research. More broadly, coordinated clinical trial networks are likely to become essential infrastructure for delivering timely, high-quality, and inclusive nephrology research.