Kidney Health, Meaning, and Human Flourishing: Toward an Integrative Approach to Precision Medicine in Chronic Kidney Disease

Background Chronic kidney disease (CKD) represents a growing global public health challenge, particularly in aging populations and fragmented healthcare systems. While precision medicine has advanced in biological risk stratification and the development of targeted therapies, significant gaps persist in health literacy, continuity of care, and active patient participation. These gaps contribute to late diagnosis and high rates of unplanned dialysis initiation. Synthesis This paper proposes an integrative conceptual framework in which kidney health is understood as a sensitive indicator of coherence between biological adaptation, living conditions, information, and meaning. Drawing on public health data-including evidence from Argentina, where approximately 72% of patients start dialysis in an unplanned manner-it highlights how educational deficits and fragmented care trajectories influence the evolution of CKD. The framework integrates contributions from existential health, inspired by the work of Viktor Frankl, and the concept of human flourishing from positive psychology, to explain how meaning, engagement, and agency influence adherence and sustained self-care. Operational Translation Furthermore, group-based clinical encounters are described as an operational model that translates this integrative framework into practice. These encounters function simultaneously as educational, existential, and precision-oriented tools, allowing for personalization without fragmentation and fostering equitable population-level kidney care. Conclusion Precision nephrology must expand beyond biomarkers to incorporate educational and existential dimensions. Integrative and group-based care models offer a scalable pathway to prevent avoidable CKD progression, reduce unplanned dialysis initiation, and promote human flourishing alongside clinical outcomes.