This bill seeks to combat end-stage kidney disease by significantly bolstering research, early intervention, and education related to rare kidney diseases. It proposes the establishment of NIDDK Centers of Excellence on Rare Kidney Disease Research to investigate causes, improve diagnosis and treatment, and raise public awareness, particularly in rural and underserved communities. These centers will also develop resources for clinical research and training, with a specific prohibition against using quality-adjusted life years or similar discriminatory metrics in research evaluations. Furthermore, the bill mandates the Secretary of Health and Human Services to conduct a comprehensive study on rare kidney disease. This study will examine the impact of routine urinalysis , the utility and barriers of genetic and genomic tests (including the APOL1 gene), and treatment patterns across various insurance programs. It will also assess access to nephrologists, social and biological factors, and patient trust among disproportionately affected populations, with a report and recommendations due to Congress within 18 months. To enhance provider capabilities, the Act amends the Public Health Service Act to include individuals with kidney disease in primary care training programs. It also authorizes nephrology fellowships to increase providers' knowledge of rare kidney disease, improve care quality for racial and ethnic minorities, and boost the number of nephrologists serving these populations. Finally, the Secretary is directed to conduct experiments on treatments that could delay or eliminate the need for dialysis and transplant, alongside a study to increase public awareness of rare kidney disease, with findings reported to Congress.