Prof. Dr. Jörg Latus is passionate about the future of kidney care and the growing potential to prevent or slow disease progression. As Medical Director of Internal Medicine and Nephrology at Stuttgart’s Robert Bosch Hospital, he is closely involved in advancing targeted therapies and translating new clinical evidence into patient care – an approach he describes as “New Nephrology.”
With rapid progress in research and an expanding range of treatment options, Latus sees a highly promising future for patients with kidney disease. Germany, with its strong healthcare system and research expertise, has an important role to play in bringing these innovations into clinical practice.
Could you introduce yourself?
I am the Medical Director of the Department of Internal Medicine and Nephrology at the Robert Bosch Hospital in Stuttgart. My clinical focus is on kidney diseases, particularly glomerular diseases, and I am also committed to increasing awareness of chronic kidney disease.
A second important part of my work is clinical research. I am involved in several phase III clinical trials, working closely with academic and industry partners. One of my main goals is to translate new clinical evidence into everyday patient care and, ultimately, to improve outcomes for patients with kidney disease across Germany.
Kidney disease receives far less public attention than cancer or cardiovascular disease. What are the main challenges around raising awareness, and what are the dangers of low awareness in Germany?
One of the particular challenges with kidney disease is that it can progress for a long time without noticeable symptoms. This makes early detection and greater awareness especially important.
At the same time, I am very encouraged by the progress we have made. We now have significantly more treatment options than we did just a few years ago. This gives us a real opportunity to change the perception of kidney disease and to focus much more strongly on prevention and early treatment.
Close cooperation between general practitioners and nephrologists will be important. If we identify patients earlier, we can increasingly intervene before substantial kidney damage occurs. This is a very positive development for the future of nephrology.
How different is the treatment landscape for kidney disease today compared to five or ten years ago?
The treatment landscape has changed enormously. Five or ten years ago, our options were much more limited. Today, we have effective therapies for the broader CKD population and, increasingly, targeted treatments for specific kidney diseases.
We now have treatments for conditions such as IgA nephropathy, C3 glomerulopathy and immune-complex MPGN, alongside established therapies for patients with diabetic, hypertensive and cardiorenal disease. The exciting development is that we can increasingly combine comprehensive CKD management with disease-specific treatment. This allows us to move towards a more personalised approach and gives many patients considerably more therapeutic options.
Does providing these targeted therapies rely on better diagnostic tools to segment patients, given how frequently kidney disease overlaps with conditions like diabetes, hypertension, or obesity?
Accurate diagnosis has always been essential in nephrology, and kidney biopsy remains an important tool when we suspect an underlying glomerular disease. The major change is what we can do once we have established the diagnosis. In the past, treatment options were often limited even when we understood the underlying disease. Today, we increasingly have targeted therapies that allow us to address specific disease mechanisms. This is an important shift in our approach. The earlier we identify the disease and understand its specific characteristics, the better we can select the appropriate treatment. I believe this will become an increasingly important part of nephrology in the coming years.
Is this new treatment approach already widespread in clinical practice, or are we still at the beginning of that transition?
We are still relatively early in this journey, but the direction is very encouraging. In many specialised centres, these therapies are already being used in accordance with clinical guidelines and approved indications. The next step is to broaden experience and education across the medical community. As awareness increases and more clinical data become available, I expect targeted treatment to become an increasingly established part of routine nephrology. We are entering a new era in kidney care, and I am very optimistic about where this development can take us.
How does Germany benchmark internationally when it comes to adopting new kidney disease therapies, and what are the main market access challenges ahead?
Germany has traditionally been very open to innovative medicines and is an important market for new therapies in Europe. In many cases, patients in Germany have access to innovative treatments at an early stage. As with every healthcare system, we also need to consider long-term sustainability. The challenge is to find constructive approaches that allow innovation to reach patients while ensuring that healthcare resources are used responsibly. I believe this is an area where continued dialogue between clinicians, industry, insurers and regulators can make a real difference. With the pace of innovation in nephrology, finding sustainable solutions will be increasingly important.
Given the tension between high pharmaceutical prices and regulatory cost constraints, where does the compromise need to come from? Who needs to bend the most?
I think there is a role for all stakeholders in finding the right balance. Innovative therapies can represent a significant investment, but they may also offer substantial benefits by slowing disease progression and potentially preventing complications such as dialysis. For me, the important point is to look at the overall value of a therapy and its long-term impact on patients and the healthcare system. We also need a constructive discussion about how clinical benefit is measured, particularly in diseases where waiting for very late outcomes may not fully reflect the value of earlier intervention. I am confident that continued dialogue can help us develop appropriate and sustainable solutions.
Germany’s competitiveness in clinical trials has slipped behind European peers like Spain. Is Germany becoming a more difficult place to conduct clinical trials?
I remain very positive about Germany as a location for clinical research. We have excellent medical expertise, strong clinical infrastructure and broad access to established therapies. At the same time, there is an opportunity to broaden the clinical trial network. Historically, university hospitals have played a very important role in clinical research, and they will continue to do so. In addition, specialised hospitals, outpatient nephrologists and general practitioners can make an important contribution because many CKD patients are treated in these settings. I see this as an opportunity to build stronger networks between all these partners. Better coordination could allow us to reach more patients and make Germany even more attractive for clinical research. For rare kidney diseases in particular, specialised reference centres and regional networks could further strengthen patient identification and trial recruitment.
What makes Stuttgart an interesting location for medical research and clinical trials, particularly given the absence of a traditional university hospital in the city?
Stuttgart is a very attractive region for medical research. It has a large population, excellent healthcare expertise and a strong innovation environment, with major companies and research-oriented organisations based in the region.
The absence of a traditional university hospital in Stuttgart does not prevent us from making an important contribution to clinical research. Rather, it creates opportunities for different institutions to work together and complement each other’s strengths. Our own experience demonstrates that specialised departments outside a traditional university setting can recruit patients very effectively and contribute successfully to international clinical trials. Looking ahead, I see considerable potential for even closer collaboration between hospitals, university medical centres, outpatient practices and industry across the region.
Germany is currently debating major hospital reforms. What impact will these proposed changes have on your work, and on German hospitals more broadly?
Healthcare systems everywhere are looking for ways to combine excellent patient care with sustainable structures. The current reforms are part of this broader discussion.
For hospitals, the coming years will certainly require continued focus on efficiency, collaboration and well-designed care pathways. We are already looking at ways to optimise processes while maintaining high standards of patient care. I also see opportunities in greater specialisation and cooperation between institutions. If we use the reform process to strengthen collaboration and develop modern models of care, it can ultimately contribute to a more efficient and patient-centred healthcare system.
What gives you the most hope and excitement as a nephrologist today, and what on the horizon gets you out of bed in the morning?
What excites me most is the speed of progress in nephrology. We now have therapies that can significantly slow disease progression, allow us to treat patients earlier and, in some diseases, give us the prospect of remission. The rapid development of clinical guidelines reflects just how quickly the field is moving. We are increasingly discussing not only how to manage kidney disease, but how we can prevent progression and achieve remission. My long-term hope is that dialysis will become much less common because we are able to diagnose and treat kidney disease earlier and more effectively. That is an ambitious vision, but the progress we are seeing today gives us good reason to be optimistic. This is what makes nephrology such an exciting field to be working in, and I am very optimistic about what the next generation of therapies can achieve for our patients.
