Paediatric Nephrology — Past Achievements and Future Goals
I wish to begin by congratulating Professor Brodehl for his decision to take time off in the middle of a highly scientific and technical symposium in order to step back momentarily from the individual clinical, scientific and technological problems of our daily work and to evaluate what we have achieved up till this day, to ask ourselves whether we are heading in the right direction and wether we are employing optimal means in order to achieve our aims. In reviewing the past of paediatric nephrology I do not intend to present a detail history, but merely to point out what seems to me some important landmarks. I see the beginning of modern paediatric nephrology in the late 1940s and early 1950s, commencing perhaps with the works of Darrow on water and electrolyte requirements and disturbances in infants and young children, and those of McCance and Widdowson on the importance of renal function in maintaining homeostasis in the growing child. Soon after came works by Lightwood on infantile renal tubular acidosis and by Fanconi on vitamin D resistant rickets, pioneering an era of detailed investigation into renal tubular function in children. This period was marked also by works demonstrating the effectiveness of cortisone, ACTH and nitrogen mustard in the treatment of childhood nephrosis, and by the performance of the first haemodialyses in children. In fact, the 1950s were marked by a tremendous surge of interest and acquisition of knowledge in numerous aspects of paediatric nephrology. Two landmarks that seem of utmost importance to me were the beginning of the training programmes in paediatric nephrology at L’Enfants Malades and at Albert Einstein in New York.
KeywordsContinuous Ambulatory Peritoneal Dialysis Haemolytic Uraemic Syndrome Nitrogen Mustard Membranoproliferative Glomerulonephritis Regional Society
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