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‘Action needed—Reviewer declined’ ‘Reviewer invitation has expired’ In the year since I became Associate Editor for the Journal of Renal Care, I have received emails with these titles over 250 times. Each represents a request for a peer review from a colleague that has either been declined or not responded to. Securing peer reviewers who have relevant subject and methodological expertise has proven to be the biggest challenge as an Editor and therefore I decided that for my inaugural Editorial, I would focus on this issue. Worldwide, there is a shortage of healthcare professionals (World Health Organisation 2020) and a crisis in higher education (Altbach and de Wit 2025). The World Health Organisation (2025) reported a shortage of 5.8 million nurses, and cited limited capacity within nurse education as a challenge. Meanwhile, a global assessment of the kidney care workforce reported shortages and the need for international strategies to address capacity limitations (Okpechi et al. 2024). These workforce challenges are particularly concerning as the incidence of chronic kidney disease and kidney failure continues to increase (Francis et al. 2024). Therefore, kidney healthcare professionals and researchers are working in increasingly difficult environments, with staff shortages and workload pressures. Receiving a request for additional, unpaid work in the form of a peer review is thus understandably difficult, and so a sincere thank you to everyone who has peer reviewed for the Journal of Renal Care this year, generously giving their time and expertise. However, the difficulty of securing peer reviewers for manuscripts has an impact. Firstly, it is frustrating for authors who have submitted carefully crafted manuscripts for review and experience long delays in receiving an outcome. This has a negative impact on the individuals and teams who rightly want to share their research with the international community, potentially impacting on future research grant applications and career progression. Secondly, but crucially, it has a negative impact on progressing the evidence base for kidney care. We all know that kidney disease and kidney failure impact severely on patients and their families. As evidence-based professions, we need access to high-quality evidence to underpin informed decision making in practice and ensure the best possible outcomes for patients. Timely publication of manuscripts that have been through a quality peer review process is therefore fundamental. Delays in the peer review process ultimately impacts on the availability of up-to-date evidence and therefore hinder decision making in practice, which is problematic for patient care. Having peer-reviewed manuscripts regularly for 14 years, I have personally found the process beneficial. It has introduced me to evidence that I was unfamiliar with, including recently published studies and different theoretical frameworks, which I have subsequently accessed and used in my own research. Peer reviewing manuscripts has enhanced my own academic writing—it has helped me to write with clarity, think like the target audience, and use a variety of writing techniques in my work. I have therefore found personal and professional benefits of the role, beyond those to the wider academic community. Ultimately, we have multiple new submissions each week to the Journal of Renal Care, which is superb and shows the range of research being undertaken by the international kidney community. All of us who submit manuscripts do so with the expectation that there will be a prompt, high-quality peer review of our research. I keep this is mind when responding to requests for peer review, as if I submit manuscripts for peer review, I also need to have a role in peer reviewing the work of others. If you are reading this and yet to review your first manuscript, please consider taking on this role. There are useful guides for completing a peer review, for example, Sedaghat et al. (2024), August and Brouwer (2024) and the Equator Network (2018). Overall, the publication of evidence is reliant on a robust peer review and the individuals who share their time and expertise to support this process. At the Journal of Renal Care, we thank all peer reviewers and hope to welcome new reviewers to the role, to support the continued publication of high-quality evidence. J.B. drafted, reviewed and approved the manuscript. The author received no specific funding for this work. I have received consultancy from Baxter and Vantive to contribute to educational projects relating to peritoneal dialysis.