Nephrologist workforce projections in the United States: anticipated shortages to 2037

BACKGROUND: Prior literature has highlighted issues regarding the supply and adequacy of nephrologists to meet increasing demands. This study analyzed disparities in the supply, demand, and adequacy of nephrologists across the United States (US). METHODS: This cross-sectional analysis of nephrologists leveraged the Health Workforce Simulation Model from 2025 to 2037. Nephrologist workforce adequacy was defined as the ratio of supply over demand. Supply and demand were defined as the number of full-time equivalent nephrologists working and needed, respectively. RESULTS: From 2025 to 2037, growth in the demand for nephrologists (15 780 to 18 860 full-time equivalents, 19.5% increase) exceeded growth in the supply of nephrologists (14 600 to 14 810 full-time equivalents, 1.4% increase). As a result, nephrologist workforce adequacy was projected to decrease over the study period from 92.5% to 78.5%. By 2037, non-metropolitan areas had lower adequacy of nephrologists when compared with metropolitan areas (24.8% vs 86.7%). The South had the lowest nephrologist workforce adequacy, and the Northeast had the highest (68.0% vs 106%). By 2037, the states with the lowest projected nephrologist workforce adequacy were Montana (28.6%), Alaska (33.3%), Idaho (40.0%), North Dakota (50.0%), and Wyoming (50.0%). CONCLUSIONS: Workforce shortages are anticipated in nephrology with notable disparities identified in non-metropolitan areas, the South, and identified states. Future work is needed to implement strategies that improve nephrologist workforce adequacy across the US.