The year 2022 provided a vivid illustration of the impacts of changing climate, with devastating floods in Pakistan and Australia, temperatures reaching 40 °C (104 °F) in the United Kingdom and over 50 °C (122 °F) in parts of India, and punishing drought and wildfires in Europe and North America. As overall temperatures rise and the frequency and intensity of extreme heat events surge, so too will morbidity and mortality from climate-sensitive kidney diseases. Facing an unprecedented challenge, we as nephrologists must both change the way we provide care to kidney patients and champion climate action.