IAHN
Editor-in-Chief: Janusz Ostrowski
Deputy Editor-in-Chief: Davide Viggiano
Editors: Maria Kalientzidou, Guido Gembillo
IAHN Bulletin is the official E-Newsletter of the International Association for the History of Nephrology
INTRODUCTION
It
is
our
pleasure
to
present
our
readers,
the
members
of
the
International
Association
for
the
History
of
Nephrology
(IAHN)
and
all
our
supporters
with
the
ninth
issue
of
the
official
IAHN
Bulletin.
Herein,
we
report
on
important
events
associated
with
our
members,
be
it
past
or
present.
This
issue
includes
the
account
of
the
Kosice
Symposium
(Slovakia)
devoted
to
our
late
friend
Professor
Miroslav
Mydlik,
information
about
the
conferences
held
in
Poland
actively
attended
by
the
Polish
IAHN
members
or
the
report
on
the
participation
of
our
members
in
the
Congress
of
the
International
Society
for
the
History
of
Medicine
in
Romania.
All
the
articles
have
been
prepared
by
the
IAHN
members
form
Slovakia,
Greece,
Italy
and
Poland.
We
are
glad
to
conclude
that
the
Bulletin
is
developing
fast
after
the
changes introduced following our latest Congress in Istanbul, Türkiye.
Before the upcoming holiday time, I would like to wish all our Friends, a Merry Christmas and a Happy New Year.
Janusz Ostrowski
Editor-in-Chief
Bulletin
No. 9, December 2022
www.iahn.info
Janusz Ostrowski
Professor,
Centre of Postgraduate
Medical Education,
Warsaw, Poland
janusz.ostrowski@cmkp.edu.pl
Board of the International Association for the History of Nephrology
Ayse Balat – President
Iwannis Stefanidis – Past President
Davide Viggiano – President Elect
Vincenzo Savica – Treasurer
Natale G. De Santo - (ex officio)
Councillors:
INTERNATIONAL
NEPHROLOGICAL
SYMPOSIUM
DEVOTED
TO
THE
MEMORY
OF
PROFESSOR
MIROSLAV MYDLÍK (*1932 – †2018) SEPTEMBER 21
st
, 2022, KOŠICE, SLOVAK REPUBLIC
The
symposium
was
dedicated
to
the
memory
of
Professor
Miroslav
Mydlík,
MD,
DSc.,
(Fig.
1)
one
of
the
leading
medical
personalities
in
Central
Europe
during
the
second
half
of
the
20
th
century,
on
the
occasion
of
his
90
th
birthday.
The
event
was
held
under
the
auspices
of
Prof.
RNDr.
Pavol
Sovák,
CSc.,
Rector
Magnificent,
Pavol
Jozef
Šafárik
University
(UPJŠ),
Košice,
in
its
Historical
Hall
(Fig.
2b).
The
organizers
invited
Professor
Mydlík‘s
good
friends
and
coworkers
to
the
symposium.
Two
participants
were
from
Italy,
Professor
Natale
G.
De
Santo
and
Professor
Guido
Bellinghieri
-
both
D.h.c.
of
Šafárik
University,
two
were
from
Poland,
Professor
Janusz
Ostrowski
and
his
wife
Maria
and
Professor
Boleslaw
Rutkowski.
Five
participants
were
from
Slovakia
–
Ing.
Katka
Derzsiová,
Ľuboslav
Beňa,
MD
-
Director
of
L.
Pasteur
Hospital,
Košice,
Professor
Oliver
Rácz,
Ass.
Professor
Ivana
Valočiková,
Professor
Ľudmila
Podracká.
All
of
them contributed with their lectures to the successful accomplishment of the event.
Figure 1. Professor Miroslav Mydlík, MD, DSc.
July 21
st
, 1932 - September 6
th
, 2018
Figure 2b.: The Historical Hall of Pavol Jozef Šafárik University
and Chorus Universitatis Šafarikianae
Figure 2a.: Opening of the Symposium. Presidium:
sitting from left to right: Prof. Oliver Rácz,
Prof. Pavol Jarčuška, Ing. Katarína Derzsiová,
Ľuboslav Beňa, M.D.
Figure 3b: Dipl. Ing. Katka Derzsiová
Figure 3a: Professor Natale G. De Santo.
Figure 3d: Professor Boleslaw Rutkowski
Figure 3c: Professor Guido Bellinghieri
Figure 3e: Professor Janusz Ostrowski
Figure 4b: Ľuboslav Beňa, MD
Figure 4a: Professor Oliver Rácz
Figure 4d:Professor Ľudmila Podracká
Figure 4c: Ass. Professor Ivana Valočiková
Figure 5: The foreign participants and Katka Derzsiová
at the grave of Prof. Mydlík in
Rozália cemetery
Figure 7: Visit to the Vojtech Löffler Museum.
From the left Professors: Oliver Rácz,
Janusz Ostrowski, Boleslav Rutkowski,
Natale De Santo, Guido Bellingheri and
Ladislav Mirossay
(former dean and rector of Šafárik University)
Figure 6: Some participants of the Symposium in front
of the Vojtech Löffler Museum. In
the background is the Cathedral of St. Elizabeth.
From left to right: Ing. K. Derzsiová, Prof. O. Rácz,
PhDr. Ž. Mácová (director of the Slovak Medical Society),
M. Ostrowska, M.D.(wife of Prof.
Ostrowski), JUDr. M. Mistríková
(the lawyer of the Slovak Medical Society)
and Prof. B. Rutkowski
Next
day
the
guests
completed
a
guided
sightseeing
tour
of
the
city
of
Košice
with
PhDr.
Milan
Kolcún,
a
certified
tourist
guide
in
the
city
of
Košice.
During
the
sightseeing
tour,
the
guests
visited
the
underground
archaeological
museum
Dolná
Brána
Košice.
Lower
Gate/Dolná
Brána
is
the
name
for
a
complex
of
underground
museum
with
the
original
entrance
to
the
city
and
the
original
walls
that
stand
out
in
the
2
nd
half
of
the
13
th
century
and
were
revealed
in
1996.
Historian
of
the
city
of
Košice,
PhDr.
Kolcún,
explained
to
the
participants
the
history
of
the
city,
which
has
been
preserved
in
the
museum.
The
next
stop
was
at
the
Cathedral
of
St.
Elizabeth.
Our
guests
listened
to
a
detailed
explanation
of
the
history
of
"The
main
Altar
of
St.
Elizabeth's Cathedral."
This
scientific
and
cultural
event
was
an
appropriate
tribute
to
the
great
physician,
with
honors
not
only
as
a
scientist
but
also
as
an
enthusiast
in
art
and
music.
Following lectures where presented at the symposium.
Katarína
Derzsiová
(Košice,
Slovakia)
in
her
lecture
"
Contribution
of
Professor
Miroslav
Mydlík,
MD,
DSc.,
to
Science
and
Clinical
Nephrology
",
presented
a
brief
biography
and
especially
the
clinical
and
scientific
achievements
of
Professor
Mydlík.
He
was
very
active
as
a
physician,
scientist,
internist
and
nephrologist,
especially
in
the
field
of
renal
replacement
therapy
in
patients
suffering
from
acute
or
chronic
renal
failure
and
with
acute
poisoning.
He
carried
out
the
first
hemoperfusion
through
active
charcoal
in
the
former
Czechoslovakia
(1977)
and
gradually
introduced
additional
extracorporeal
elimination
methods
and
CAPD.
He
was:
The
Head
of
the
Fourth
Internal
Clinic;
founder
and
Head
of
the
Nephrological
Clinic
of
the
University
Hospital
of
L.
Pasteur,
the
first
in
Slovakia;
UPJŠ
vice-rector;
and
principal
expert
for
nephrology
of
the
Ministry
of
Health
of
the
Slovak
Republic.
In
2015
he
was
introduced
into
the
"Hall
of
Glory
of
the
Slovak
Medicine".
His
lifelong
literary
interest
was
Franz
Kafka's
works.
He
left
a
historical impact on the field of nephrology in Slovakia, former Czechslovakia, and also on the international medical and scientific society.
Natale
G.
De
Santo
(Naples,
Italy)
started
his
lecture
with
a
very
nice
thoughts
"Great
men
are
like
mountains.
At
their
foot
it
is
impossible
to
see
their
summit.
It
becomes
visible
when
walking
away
from
them."
He
adopted
also
the
words
of
Jean
Guitton,
the
most
important
Catholic
philosopher
of
the
last
century
in
France,
"
The
Friend
has
gone
":
"The
death
of
a
friend
generates
a
great
vacuum.
It
is
not
just
the
vacuum
of
absentia
which
is
irreparable
too.
It
generates
the
feeling
that
part
of
ourselves
lacks
now
approval,
reflex,
echo,
and
criticism.
John´s
Gospel
renders
in
a
simple
and
sublime
way
the
distress
of
a
person
which
is
conscious
that
a
fragment
of
his
life
is
now
settled
in
the
past,
because
the
friend
has
gone.
One
might
say
the
whole
gospel
derives
from
this
transformation
of
the
time,
which
just
for
departure
of
a
friend
is
turned
in
a
time
past,
an
old
testament.
I
have
experienced
on
many
occasions the inexorable death of part of myself due to the death of another person.“
In
his
presentation
“
Renal
Stone
Disease
in
Roman
Pontiffs
“
he
pointed
out
recent
studies
that
have
shown
that
popes
represent
an
interesting
model
to
study
kidney
stone
disease.
Gout
and
uric
acid
stones
affected
26
out
of
264
popes
(9.84%)
reigning
in
the
years
34
–
2005
AD.
Eleven
out
of
264
popes
were
non-gouty,
calcium(?)
stone
formers
(4.1%).
Why
so
many
popes
were
stone
formers?
They
consumed
relatively
higher
amounts
of
animal
protein
and
sodium.
High
protein
intake
causes
hypercalciuria
due
to
bone
reabsorption,
due
to
acid
load,
high
filtered
calcium
load.
Salt
intake
(urinary
sodium),
correlates
with
the
prevalence
of
hypercalciuria,
independently
of
intestinal
Ca
absorption
and
mainly
via
renal
mechanism.
Out
of
26
popes
with
gout,
18
had
kidney
disease
and
8
were
without
kidney
disease.
Age
at
death
(Mean
±
SEM)
of
8
out
11
popes
with
kidney
stones
of
non-gouty
origin
-
of
whom
we
know
exactly
the
data
of
birth
-
was
63.1±2.66
years,
significantly
shorter
(p<0.056)
than
that
of
popes
with
kidney
stones
of
gouty
origin
who
died
at
73.2
±3.02
years.
De
Santo
concluded
by
explaining
that
popes
had
gout
at
a
time
when
average
people
did
not
eat
meat
or
drink
alcohol.
Now
gout
is
disappeared
from
the
Vatican
Palaces,
whereas
the
general
population
that
has
conquered
the
same
papal
life
span,
starts
suffering
of
gout
and
kidney
stone disease. It occurs in the population who did not accept to change their lifestyle.
Guido
Bellinghieri
(Messina,
Italy)
proclaimed
present
difficulties
of
transplantation
in
his
lecture
“Organ
Donation
and
Transplantation
Today“.
The
shortage
of
organ
donation
and
subsequent
transplantation
requires
a
great
effort
to
increase
the
number
of
donors.
Many
important
factors
are
needed
to
increase
organ
donation:
cultural,
religious,
ethical
and,
above
all,
the
congenital
inclination
towards
donation.
Organ
donation
offers
one
person
to
change
the
lives.
All
countries
must
work
together
in
order
to
increase
the
number
of
organs
available
for
patients
requiring
organ
transplants
by
adopting
well-specific
programs.
An
important
role
must
be
played
by
the
registries
in
providing
data
on
organ
donation,
geographic
distribution,
transplant
activities and outcomes.
Lecture
by
Professor
Janusz
Ostrowski
(Warsaw,
Poland)
with
the
title
"
Gustaw
Piotrowski
(1833
-
1884)
-
Discovery
of
Protein
Reaction
"
was
a
celebration
of
the
Polish
physiologist
G.
Piotrowski,
who
independently
of
Ferdinand
Rose
described
the
Biuret
reaction
(1857).
Biuret
reaction
it
is
one
of
the
most
commonly
used
reactions
in
protein
chemistries
and
it
is
an
important
step
in
the
diagnosis
of
renal
disease.
In
1857
he
started
working
at
the
Department
of
Physiology
of
the
Jagiellonian
University
and
in
1860
he
became
its
professor
and
Head.
Gustaw
Piotrowski
also
held
the
honorable
functions of Dean and Rector of this University in Krakow. One of the first and most important was his work on the biuret reaction.
Boleslaw
Rutkowski
(Gdańsk,
Poland)
in
his
lecture
"
Climate
Changes
and
Kidney
Disease
"
pointed
out
the
negative
impact
of
climate
change
on
human
health,
the
increased
possibility
of
kidney
damage
due
to
lack
of
food
and
dehydration.
All
changes
influencing
the
climate
system
are
dependent
on
human
influence
and
production
of
CO2
excess
pollution
from
coal,
natural
gas
and
oil.
Climate
change
through
heat
stress,
storms,
flooding,
air
pollution,
food
and
water
shortage
are
leading
to
increased
morbidity
and
mortality
mainly
due
to
respiratory
and
cardiovascular
diseases
and
malnutrition.
Heat
stroke
coupled
with
increasing
water
shortage
are
increasing
our
risk
for
dehydration
-
associated
with
kidney
disease
including
kidney
stones, acute kidney injury and heat-stress CKD. CKD occurs especially in agricultural workers in hot and humid environments.
Ľuboslav
Beňa
(Košice,
Slovakia),
in
his
presentation
"
Living
Donor
Kidney
Transplantation
(LDKT)
"
confirmed
that
this
modality
is
considered
as
the
best
treatment
option
for
patients
with
end
stage
renal
disease.
The
main
prerequisites
for
living
kidney
donation
are
(1)
stable
long-term
kidney
function
in
a
donor
and
(2)
safety
of
the
donor
nephrectomy.
Between
years
2015
and
2019,
81
LDCTs
were
performed
in
four
Transplant
Centers
in
Slovakia.
78
donors
were
included
in
the
analysis
of
GFR
with
a
mean
follow-up
of
3
±
1.4
years.
They
evaluated
the
impact
of
predonation
eGFR,
age,
and
arterial
hypertension
on
the
severity
of
the
change
in
eGFR
after
kidney
donation.
This
study
demonstrates
a
favorable
course
of
donor
nephrectomies
as
well
as
midterm clinical outcomes of the donors. However, long-term care and follow-up of living donors is necessary.
Ivana
Valočiková
(Košice,
Slovakia)
pointed
out
in
her
presentation
"
Systemic
Vasculitis
–
Latest
Treatment
Recommendations
"
on
the
latest
recommended
treatment
of
this
disease.
Systemic
vasculitis
comprises
a
spectrum
of
diseases
affecting
small
and
medium-sized
vessels
and
can
cause
severe
acute
renal
failure
through
glomerular,
interstitial,
and
vascular
damage.
Granulomatosis
with
polyangiitis
(GPA,
former
Wegener
granulomatosis),
microscopic
polyangiitis
(MP)
and
eosinophilic
granulomatosis
with
polyangiitis
(eGPA,
former
Churg-Strauss
syndrome)
are
grouped
under
the
term
ANCA-associated
vasculitis
(AAV).
AAV
without
immunosuppressive
therapy
is
associated
with
poor
prognosis.
In
2021
KDIGO
issued
new
recommendations
for
both
induction
and
maintenance
treatment.
For
new-onset
AAV
in
induction
treatment
is
recommended
combination
of
glucocorticoids
with
cyclophosphamide
or
rituximab.
Plasma
exchange
is
recommended
for
patients
with
rapidly
increasing
CrS
(˃
500
μmol/L)
and
in
persons with diffuse alveolar haemorrhage with hypoxemia.
The
lecture
by
Oliver
Rácz
(Košice)
and
Bertalan
Fodor
(Miskolc)
"
Current
Trends
in
Laboratory
Assessment
of
Renal
Function
"
confirms
that
diabetic
nephropathy
is
the
most
common
cause
of
terminal
kidney
failure.
Recently
strong
emphasis
is
put
on
early
achievement
of
very
good
compensation
as
soon
as
possible
after
diagnosis
also
in
type
2
diabetic
patients
similar
to
type
1.
To
achieve
this
aim,
it
is
necessary
to
use
reliable
and
simple
markers
of
renal
function.
The
basic
level
of
renal
function
assessment
remains
the
calculation
of
glomerular
filtration
rate
and
the
estimation
of
albuminuria
from
serum
creatinine.
In
the
near
future
there
is
a
need
to
replenish
these
basic
markers
with
new
biomarkers
based
on
the
latest
results
of
genetic
and
epigenetic studies.
Ľudmila
Podracká
et
al.
(Bratislava,
Slovakia)
pointed
out
in
the
lecture
"
Dynamics
of
Salivary
Markers
of
Kidney
Functions
in
Acute
and
Chronic
Kidney
Disease
"
that
saliva
can
be
used
as
an
alternative
diagnostic
fluid
enabling
easy
and
non-invasive
disease
monitoring.
Urea
and
creatinine
can
be
measured
in
saliva
and
both
were
shown
to
be
increased
in
renal
failure.
Authors
monitored
the
dynamics
of
these
parameters
in
AKI
and
CKD
at
different
stages
in
animal
and
human
models.
Plasma
and
salivary
concentrations
of
urea
and
creatinine
correlated
in
children
with
renal
failure,
but
not
in
controls. Saliva could be used for non-invasive monitoring in higher stages of AKI or CKD, rather than for screening of early stages of kidney diseases.
Acknowledgements
I am thankful to Professor Janusz Ostrowski, to Dionýz Kiss from the University Hospital of L. Pasteur, Košice, and to Mrs. Žofia Hnátová from the
Faculty of Medicine of UPJŠ, Košice, for providing photographs from the Symposium.
48
th
CONGRESS OF THE INTERNATIONAL SOCIETY FOR THE HISTORY OF MEDICINE
Figure 1.: The venue of the Congress
Figure 2. Frescoes on Orthodox Chuches.
Professor
Baran
should
also
be
deeply
thanked
for
her
persistence
to
organize
a
Joint
ISHM-IAHN
Session
according
to
the
agreement
between
the
two
Bodies
signed
in
Larissa
Greece
2020
by
Professor
Janusz
Ostrowski
and
myself
(on
behalf
of
Professor
Carlos
Viesca).
In
the
Iasi
Congress
the
following papers were read by IAHN Members:
A) Prof. Dr. Natale Gaspare de Santo presented three topics.
1)
For
the
history
of
sleep
apnea
in
kidney
disease.
He
elaborated
on
some
abnormalities
caused
by
SA.
Indicatively,
hypoxemia
and
oxidative
stress
as
associated
with
diabetes
mellitus,
cardiovascular
morbidity
and
mortality.
SA
is
not
cured
by
dialysis
or
peritoneal
dialysis;
is
cured
by
nocturnal
daily
hemodialysis
and
by
cycler
assisted
peritoneal
dialysis
and
is
ameliorated,
but
not
cured,
by
transplantation
probably
for
the
fact
that
the
transplanted
kidney is denervated; It is cured by CPAP.
2)
Malaria,
A
Papal
disease.
His
paper
started
with
malaria’s
first
appearance
in
Venice
in
the
XV
continued
with
the
stories
of
all
Popes
affected
by
the
disease
from
the
early
periods
of
the
Papacy
till
a
century
ago.
Rome
and
the
Pontine
plain
have
been
malarial
sites.
So
being
pope
and
obliged
to
reside
in Rome represented a risk factor for contracting the disease.
3).
Septic
acute
kidney
injury,
a
leading
cause
of
20
Papal
deaths
in
the
years
1277-2005.
This
study
found
that
a
total
of
21
of
78
popes
(26.9%)
reigning
between
the
years
1277-2005,
died
of
AKI.
Sepsis
was
identified
as
the
leading
cause
of
Acute
Kidney
Injury
and
death
in
20
of
these
21
(95.2%) popes. Age at death of the 21 popes was 69.4±2.26 years
B)
Prof.
Diamandopoulos
Athanasios
presented
four
papers
in
the
Iasi
Congress.
Two
of
them
were
introductions
to
specific
sessions
incorporated
in
the
Congress. One of them was the Joint ISHM/IAHN Session where he presented the paper:
1)
Nephrology
as
a
craft
and
not
as
a
science,
according
to
some
Hippocratic
writings.
It
was
about
Hippocrates’
relation
of
cooking
with
the
regulation
of
a
balanced
internal
mileu
of
a
healthy
and
an
ill
person.
The
paper
elaborated
on
its
application
to
achieving
a
normal
pH
of
a
human
either
by
giving
neutralizing
agents
or
by
subtracting
damaging
ones.
The
second
specific
session
was
devoted
to
the
celebrations
of
the
800
years’
anniversary
of the Padua University. In this session the paper:
2)
The
links
between
the
Medical
school
of
Padua
and
the
Hellenic
Medical
World
was
presented.
It
reported
the
lives
and
works
of
ten
famous
medical
doctors
and
politicians
of
Greek
origin
who
studied
in
Padua
during
the
17
th
and
18
th
centuries.
In
the
main
Congress
he
presented
two
more
papers:
3)
Two
different
ideologies
between
the
bodies’
cremation
in
the
past
and
during
the
current
times.
His
conclusions
were
that
since
Homer
till
very
recently in India cremating pyres had always a religious content. In modern times they are gradually losing it reaching a covered or not atheistic element.
4)
Debunking
the
myths
about
Hippocrates.
The
author
debunks
several
urban
myths
about
Hippocrates’
lack
of
faith,
his
patriotism,
his
teaching
under
the
Cos
Plane
Tree,
even
the
authorship
of
the
Oath.
He
further
discusses
the
modern
political,
social
and
cultural
climate
that
is
against
the
Hippocratic principles and underscores his belief that only a few devoted physicians and Societies could still adhere to the Oath.
C) Professor Ioannis Stefanidis presented:
1)
Kidney disease in “Physica” by Hildegard von Bingen (1098-1179).
Hildegard
von
Bingen
(Hildegardis
Bingensis;
Saint
Hildegard)
also
known
as
or
“Sibyl
of
the
Rhine”
(1098–1179
AD),
was
a
Benedictine
abbess,
musician,
poet,
writer,
counselor
and
healer.
Hildegard
von
Bingen’s
medical
work
is
collected
in
two
books
(1152-1163
AD):
“Physica”
and
“Causae
et
curae”.
The
aim
of
this
paper
was
to
investigate
the
characteristics
of
the
nephrology
oriented
remedies
in
“Physica”
and
compare
them
with
the
respective
remedies
in
“de
Materia
Medica”
(1st
cent
AD)
by
Dioscorides
Pedanios
Anazarbeus.
“Physica”
is
a
collection
of
nine
books
with
an
inventory
of
plants,
trees,
elements,
stones,
animals,
and
metals,
describing
their
natural
therapeutic
properties.
Among
all
plants
there
were
15
(5.1%)
of
nephrological
interest
(11
within
the
section
of
plants
and
4
within
the
section
of
trees).
Only
some
of
the
natural
ingredients
were
found
with
the
same
indication
in
the
ancient
text
(9
out
of
15).
The
nephrological
treatment
indications
found
included
dysuria,
nephritic
pain
and
lithiasis
in
87%
and
dropsy
(oedema) in 13.0% - comparable with 10% in the Materia Medica.
D) Professor Ayse Balat also presented one paper:
1)
A
study
on
urinary
system’s
anatomy
knowledge
and
illustrations
in
the
17th
century
Turkish
anatomy
book
Tashrīḥ
al-abdān
wa
tarjamān
qıbāla
faylasūfān
by
shams
al-dīn
ʿiṭāqī.
Starting
from
ancient
times,
information
about
human
anatomy
has
been
given
either
as
a
part
of
medical
works
or
independent
works
have
been
written
on
this
subject.
Shams
al-dīn
ʿIṭāqī’s
Tashrīḥ
al-abdān
wa
tarjamān
ḳıbāla
faylasūfān
(1632)
was
an
illustrated
Turkish
book
written
exclusively
on
anatomy
in
the
17th
century.
Aim
of
this
study
was
to
evaluate
both
anatomical
knowledge
and
figures
on
urinary
system
and
to
comment
on
achieved
results.
Tashrīḥ
al-abdān
wa
tarjamān
qibāla
faylasūfān
with
its
some
Eastern
and
European
style
illustrations, can be estimated as the bridging work between Ottoman and European treatises on human anatomy
PRO PATRIA ET HUMANITATE
Figure 1. The title page of the Conference programme.
Figure 2. Exhibition Pro Patria et Humanitate.
From the left: prof. Janusz Ostrowski,
prof. Jarosław Pinkas (photo Maria Ostrowska)
Figure 3. Prof. Janusz Ostrowski during the lecture
(photo Jarosław Pinkas)
PROGRESS IN NEPHROLOGY AND HYPERTATION
Nephrology,
a
new
field
of
science
within
internal
medicine,
began
to
emerge
in
Poland
in
the
mid-twentieth
century.
In
1958,
the
first
nephrology
clinic
was
established
in
Wrocław,
followed
by
other
academic
centres
in
the
early
1970s.
In
the
1960s,
the
Nephrology
Section
started
functioning
within
the
Society of Polish Internists, and the first conferences in nephrology began to appear.
In
1983,
several
renowned
Polish
nephrologists
led
by
Profs.
Franciszek
Kokot
and
Zenon
Szewczyk
set
up
the
Polish
Society
of
Nephrology
(PTN)
in
Bydgoszcz
with
the
task
of
holding
national
scientific
and
training
conferences
every
year
and
election
conventions
every
three
years.
Simultaneously,
PTN
branches
organising
local
conferences
started
to
stem.
Some
of
those
small-scale
meetings
later
grew
into
national
scientific
events
held
partly
independently
of
the
PTN.
These
include
the
Katowice
Seminars
Progress
in
Nephrology
and
Hypertension
,
the
Post
ASN
Meeting
in
Gdańsk,
or
Top
Nephrological
Trends
in
Poznań.
Here,
however,
we
will
only
talk
about
the
Seminar
in
Katowice,
which
occupies
a
unique
place
on
the
scientific
and
training map of nephrology and hypertension.
In
2000,
following
prof.
Franciszek
Kokot's
retirement,
the
management
of
the
Department
and
Clinic
of
Nephrology,
Endocrinology
and
Metabolic
Diseases
of
the
Medical
University
of
Silesia
was
taken
over
by
his
natural
successor
and
one
of
the
many
outstanding
students,
prof.
Andrzej
Więcek
(Fig.
1).
Currently,
the
clinic
is
called
the
Department
and
Clinic
of
Nephrology,
Transplantation
and
Internal
Diseases
of
the
Medical
University
of
Silesia
in
Katowice.
Though
probably
conceived
of
much
earlier,
one
of
A.
Więcek's
initiatives
as
its
Head
was
the
organisation
of
the
Katowice
Seminar
Progress
in
Nephrology
and
Hypertension.
The
initiative
was
undoubtedly
inspired
by
the
seminars
run
in
Heidelberg,
Germany,
by
prof.
Eberhard
Ritz
widely
known
for
his
close
scientific
and
personal
relationship
with
the
staff
of
the
centre
of
nephrology
in
Katowice.
Professor
Ritz
is
one
of
the
most
internationally recognised nephrologists, who has attended most of the Seminars and was a member of its Scientific Committee (Fig. 2).
Figure 2. Professor Eberhard Ritz
(photo Janusz Ostrowski)
Figure 1. Professor Andrzej Więcek
(photo Janusz Ostrowski)
Professor
A.
Więcek
intended
to
have
a
three-day-long
annual
scientific
meeting,
during
which
the
most
burning
issues
of
broadly-understood
nephrology
and
hypertension
would
be
presented
by
renowned
Polish
and
foreign
experts
in
the
fields.
The
discussions
are
intended
mainly
for
specialists
in
the
field
of
nephrology,
transplantation
medicine
and
hypertension,
and
the
main
topics
include
clinical
nephrology,
dialysis,
organ
(kidney)
transplantation
and
all
the aspects of hypertension. The first Katowice Seminar was held on 8-10 November 2001.
This
year,
the
22
nd
Katowice
Seminar
took
place
on
24-26
November
with
the
active
participation
of
several
members
of
the
International
Association
for
the
History
of
Nephrology
(IAHN)
(Fig
3).
The
first
of
them
was
prof.
Przemysław
Rutkowski,
a
former
member
of
the
IAHN
Board,
who
presented
a
lecture
on
Heart
insufficiency
in
chronic
kidney
disease
(Fig.
4).
Then,
on
the
same
day,
Prof.
Janusz
Ostrowski
gave
a
typically
historical
speech
entitled
Great
epidemics
over
the
centuries
(Fig.
5).
Additionally,
Prof.
Bolesław
Rutkowski,
the
former
President
and
an
honorary
member
of
our
society,
and
prof. J Ostrowski chaired scientific sessions (Fig. 6).
Figure 4. Professor Przemysław Rutkowski
during his lecture (photo Janusz Ostrowski)
Figure 3. From the left: prof. Piotr Jankowski, prof. Ryszard Gellert,
prof. Janusz Ostrowski (photo Maria Ostrowska)
Figure 6. Professor Janusz Ostrowski during his lecture
(photo Maria Ostrowska)
Figure 5. Professor Janusz Ostrowski as the chair
of a session (photo Maria Ostrowska)
EDITORIAL
COMMENT
ON
THE
ANALYSIS
BY
PROFESSOR
ATHANASIOS
DIAMANDOPOULOS
ON
IAHN
ACTIVITIES
We
have
received
an
interesting
analysis
by
prof
Diamandopoulos
about
the
activities
of
our
Association,
presented
in
Vienna
in
2016.
These
represent
an
excellent
snapshot
of
IAHN
activities
up
to
five
years
ago.
While
awaiting
an
update
about
the
editorial
production
of
IAHN
in
2016-2022,
it
is
helpful
to
rethink
our
scientific
interests,
how
these
have been changed over time, and where we are going.
Therefore,
I
thank
prof
Diamandopoulos
for
this
helpful
analysis,
which
deserves
a
comment
from
the
Editors
because
they can guide the future activities of the association.
According
to
prof
Diamandopoulos’
analysis,
In
the
period
1997-2016,
IAHN
has
produced
363
papers,
which
have
been
published
in
two
major
journals:
American
Journal
of
Nephrology
and
Journal
of
Nephrology.
The
association
also
participated
in
the
ERA-EDTA
Congresses
with
several
abstracts.
We
can
say
this
high
productivity
has
maintained up today, as evidenced by our website.
The manuscripts came from different nations, which underlines the international nature of the association.
The two graphs reported in Figure 1 are fascinating to us.
Figure 1. Two graphs (slightly modified)
from prof Diamandopoulos’s presentation at
IAHN meeting in Vienna 2016
(courtesy of prof Diamandopoulos).
On
one
side,
we
recognize
a
strong
trend
in
our
community
towards
biographical
descriptions
in
the
History
of
Nephrology.
Biographic
data
of
crucial
persons
in
the
history
of
nephrology
are
very
important
for
the
historian
who
seeks
to
understand
how
a
specific
theory
was
developed
over
time
and
what
has
helped
a
scientist
to
arrive
at
a
groundbreaking
experiment
or
a
breakthrough
idea.
Compiling
biographical
data
is
a
highly
time-consuming
task,
as
it
requires
the
analysis
of
several
sources
(sometimes
contradictory)
to
gather
objective
information
about
the
life
of
a
person
and
his/her
role
in
a
field
of
study.
Comparing
the
second
graph
in
Figure
1,
we
can
also
understand
that
many
of
these
biographical
data
pertain
to
modern
scientists
or
nephrologists.
Again,
this
is
a
remarkable
peculiarity
of
our
society,
as
many
of
our
members
feel
the
importance
of
reporting
information
about
great
nephrologists
who
have
been
fundamental
in
developing
some
aspects
of
nephrology
in
a
specific
country.
An
overview
of
these
manuscripts
suggests
that,
in
many
cases,
the
authors
knew
the
scientist
personally
in
the
bibliographic
account,
thus
adding
their
own
experience
with
the
subject.
This,
indeed,
is
very
valuable
for
the
historians
of
the
future,
who
will
find
a
collection
of
information
from
people
who
personally
knew
the
subject
of
the
biographic
study.
In
perspective,
it
would
be
nice
if
our
community
devoted
time
to
improving
the
biographic
accounts
found
on
Wikipedia
and
which
usually
represent
the
first
source
to
retrieve (freely and rapidly) information about a specific scientist or famous physician.
I
think
that
two
other
aspects
are
interesting:
1)
fewer
manuscripts
from
IAHN
have
analyzed
science
in
the
renaissance
and
ancient
times.
While
the
analysis
of
nephrological
aspects
in
ancient
times
is
limited
by
the
scant
sources
and
possibly
some
lack
of
attention
towards
the
kidneys
in
ancient
times,
the
renaissance
manuscripts
certainly
deserve
much
more
attention
from
our
community
as
they
contain
a
large
amount
of
material
(usually
in
Latin)
and
may
offer
insights
about
"atypical"
medical
views
which
might
have
preceded
(and
possibly
inspire)
non-Galenic
positions
in
subsequent
periods.
We
should
also
take
advantage
of
the
availability
of
some
of
these
manuscripts
in
the
web
and
from
the
excellent
performance
of
Google
Translate
in
translating
from
Latin;
2)
in
the
classification
of
Fig
1
there
is
no
tag
for
“mechanisms
of
discovery”
or
“epistemiology”
or
“nosology”.
Obviously,
there
have
been
publications
by
IAHN
dealing
with
these
aspects,
but
I
like
to
remark
on
how
this
item
is
very
important
for
the
modern
nephrological
sciences.
Modern
science
is
often
inclined
at
proposing
theories,
classifications,
or
treatments
without
noticing
that
these
have
been
already
proposed
in
the
past.
One
example
is
the
diet
in
nephrological
patients
or
the
role
of
uric
acid.
Another
example
is
the
modern
classification
of
shock
into
dry/wet
and
warm/cold,
which
resembles
Galenic
notions.
I
feel
that
the
studies
produced
by
IAHN
would
be
greatly
helpful
to
the
modern
scientist
if
only
he/she
understands
how
to
use
these
historical
notions:
I
do
not
see
why
the
historian
(and
particularly
the
historian
nephrologist)
should
not
guide
the
reader
in
this direction at least in the abstract of a historical study.
I like to conclude by quoting part of the nice letter from prof Diamandopoulos:
“[…]
I
attach
the
illustrations
for
a
lecture
delivered
by
me
during
the
IAHN
Vienna
Meeting.
Later,
it
was
inserted
in
the
section
"library"
in
our
website
as
it
was
thought
that
it
was
giving
a
quick
answer
to
the
readers
about
the
overall
scientific
profile
of
the
Association.
[…]
As
I
think
that
numbers
have
a soul, as elegantly expressed by the following extract:
On numbers
In writing the history of nephrology, as in most histories
of science, numbers are strong signals, are
precise, never emphatic, do not lie, and express our
rational soul. Numbers have a ”heart and a soul” and
“allow us to answer the question who are we?, they
are what allows us to make ourselves identified” [1].
[1]Napoletano R. L’altra Domenica I Radio 24. Il sole 24ore.21/11/2015, p.23, col.1-2 ”
ON THE VOCATION OF THE SCHOLAR: HOW YOUTUBE HELPS TO SATISFY FICHTE'S REQUESTS
Johann
Gottlieb
Fichte
(1762-1814),
in
“The
Vocation
of
the
scholar”,
developed
his
accounts
on
the
role
of
the
scholar
in
society,
his
social
function:
the
scholar
has
the
moral
duty
of
furthering
human
culture
and
progress;
to
do
this
the
scholar
must
also
possess
historical
knowledge.
I
find
this
position
inspirational
for
my
work,
and
maybe
it
gives
an
additional
view
of
our
History
of
Nephrology
Association:
not
only
delving
with
the
advancement
of
historical knowledge but also actively spreading it in society.
Indeed,
today
there
is
a
strong
tendency
to
encourage
scientists
to
exit
from
their
laboratories
and
libraries,
and
to
encounter
the
"great
public",
so
that
everyone
knows
how
science
work,
why
specific
experiments
are
needed,
what
are
the
limitations
of
science,
and
the
like.
The
European
Association
of
Nephrology
follows
this
trend,
with
many
initiatives
towards
the
non-nephrological
community.
The
"world
kidney
day"
is
another
example
of
this
attempt (https://www.worldkidneyday.org/).
Within this tendency, I like to report what the History of Medicine division of the National Library of Medicine has organized.
As
the
reader
may
know,
the
National
Library
of
Medicine
(NLM)
is
a
part
of
the
American
National
Institute
of
Health
(NIH).
It
is
an
organism
started
in
1836
and
today
is
"the
world’s
largest
biomedical
library
and
a
leader
in
research
in
computational
health
informatics".
Pubmed
(probably
the
most
used
search
engine
in
the
world
of
science)
is
a
product
of
the
NLM.
It
has
a
division
of
History
of
Medicine
(HMD).
On
its
website,
the
HMD
gives
access
to
manuscripts, films, photographs, and rare books ( https://www.nlm.nih.gov/hmd/index.html ), a collection of wonderful material for the historian.
Here
I
want
to
underline,
however,
how
HMD
takes
care
to
its
social
mission:
this
division
has
created
an
entire
set
of
videos,
available
on
Youtube,
called "NLM history talks".
The interested reader can see the videos at the following link:
https://www.youtube.com/@NLMNIH/videos
The
NLM
is
not
the
only
organization
that
gives
attention
to
its
social
role
using
the
Youtube
channels:
the
International
Society
of
Nephrology
(ISN)
goes
in
the
same
direction
with
a
specific
Youtube
channel
called
"Nephrology
Video
Legacy
Project".
This
channel,
hosted
on
Youtube,
counts
187
videos
curated
by
Kim
Solez
and
J
Stewart
Cameron,
with
modern
and
ancient
interviews
with
many
scholars
in
the
field
of
Nephrology.
Here
is
the
link
to the channel:
https://www.youtube.com/@KimSolez
If
only
I
could
express
a
desire
before
Christmas
regarding
our
Association,
it
would
be
to
have
available
the
innumerable
high-quality
lectures
and
the
precious
historical
material
presented
over
the
years
during
our
meetings,
similar
to
the
example
of
NLM.
This,
of
course,
would
require
time
and
dedication;
however,
this
would
be
compensated
by
the
role
that
our
Association
would
have
in
society,
transmitting
to
a
more
enormous
public
not
only
the
passion
for
History
(and
history
of
nephrology
in
particular),
but
also
giving
instruments
to
young
students
and
doctors
to
understand
better
where
we
are today and how we did arrive there.
Davide Viggiano
Dipl. Ing. Katarina Derzsiova
University Hospital of L. Pasteur
Košice, Slovak Republic
Professor
Athanasios Diamandopoulos
Louros Foundation
for the History of Medicine
Athens, Greece
Maria Kalientzidou
Renal Unit
/Nephrology Department
General Hospital
of Kavala, Greece
THE “UNGRATEFUL” FACE OF MEDICINE.
The
history
of
medicine
is
a
series
of
great
achievements
and
epic
mistakes.
Personally,
I
cannot
say
which
is
more
but
the
continuous
progress
of
medicine
suggests
at
least
a
"kind"
of
balance
between
them.
Medicine
is
also
full
of
twists
and
turns
concerning
mainly
treatment
modalities.
Nephrology
as
a
“fledgling”
speciality
that
is
still
being
structured and maturing could not be an exception.
Treatment
of
acute
kidney
injury
(AKI)
and
of
end-stage
kidney
disease
(ESKD)
includes
two
dialysis
options,
haemodialysis
(HD)
and
peritoneal
dialysis
(PD).
Studies
from
Europe
and
North
America
indicate
that
more
than
two-thirds
of
incident
patients
do
not
have
a
medical
contraindication
for
either
HD
or
PD.
Nephrologists
estimate
that
roughly
half
of
the
patients
with
ESKD
are
good
candidates
for
PD
and
patients
strongly
prefer
PD
when
given
the
option(1).
A
significant
subset
of
ESKD
patients
do
not
receive
pre-ESKD
education
or
access
planning
and
the
majority
of
them
(sometimes
referred
to
as
“crash
ESKD”)
are
treated
with
urgent-start
HD
through
a
central
venous
catheter(2).
On
the
other
hand,
acute
PD
as
a
modality
to
treat
AKI
has
become
underutilized
due
to
the
lack
of
familiarity
of
nephrologists
with
the
use
of
PD
in
the
acute
setting
and
the
perception
that
PD
portends
inadequate
clearance and ultrafiltration.
Although
survival
benefits
for
HD
over
PD
have
not
been
demonstrated,
and
considering
that
PD
is
more
cost-
effective
in
developed
countries
studies,
one
would
expect
to
see
increasing
rates
of
PD
use.
However,
studies
and
registries
have
reported
a
decrease
in
the
percentage
of
PD
utilization(3).
Worldwide,
PD
accounts
for
9%
of
all
kidney
replacement
therapy
(KRT)
and
11%
of
all
dialysis
and
more
than
half
of
all
patients
receiving
PD
resided
in
four
countries
(China,
USA,
Mexico
and
Thailand)(4).
Nevertheless,
PD
use
has
decreased
worldwide
and
has
been
extremely limited in North America and Europe (5).
The
reasons
for
this
underutilization
may
be
a
lack
of
familiarity
with
the
technique
by
nephrologists,
intensivists
and
nursing
staff,
and
the
ease
of
ordering
CVVH
by
the
physicians.
Surveys
of
US
academic
medical
centers
indicated
that
they
do
not
devote
enough
time
for
fellows
to
develop
expertise
in
the
care
of
PD
patients.
More
than
half
of
practicing
nephrologists
in
the
USA
reported
that
they
were
trained
mainly
in
providing
care
for
HD(6).
Unease
about
the
certainty
of
ultrafiltration
and
clearance
potential
and
misconceptions
regarding
complications
or
effectiveness
despite
many
positive
trials
may
also
contribute
to
a
reluctant
use
of
PD.
The
decline
of
PD
cannot
be
explained
only
by
medical
reasons
but
by
management
and
health
care
policies
also.
The
rapid
increase
in
the
number
of
HD
facilities,
expansion
of
the
preexisting
clinics
by
increasing
the
number
of
HD
units,
and
increase
in
the
number
of
HD
shifts
or
overnight
shifts
have
led
to
greater
use
of
HD.
Whatever
the
causes,
this
has
resulted
in
a
downward
spiral
where
the
loss
of
experience
and
insufficient
knowledge
on
important
pathophysiological
issues
of
PD
modality,
and
healthcare
strategies
have
resulted
in
almost
exclusive
attention
to
HD
and
an
“ungrateful”
attitude
to
PD,
a
dialysis
modality
that
has
“faithfully”
served
and
continues
to
serve
the
needs
of
kidney patients.
But
life
is
unpredictable
and
twists
and
turns
are
not
unusual;
the
most
striking
example
is
the
Covid-19
pandemic
which
created
an
unprecedented
strain
on
healthcare
systems
around
the
world.
The
Covid
pandemic
pushed
the
medical
world
to
its
limits
by
challenging
conventional
approaches
and
exhausting resources. It has forced us to face the reality and recruit pre-existing options, like PD that we have previously ignored and underutilized.
AKI
is
one
of
the
most
serious
complications
of
Covid-19
and
a
major
determinant
of
resource
utilization,
especially
if
renal
replacement
therapy
is
required(7).
High
rates
of
AKI
were
reported
in
Italy
and
New
York.
The
dramatic
Covid
surge
in
March
2020
in
New
York
City
threatened
to
overwhelm
hospital
capacity
for
kidney
replacement
therapy
provision
(KRT)(8).
The
growing
number
of
AKI
patients
in
combination
with
a
limited
pool
of
trained
staff,
scarce
supplies
of
continuous
replacement
therapy,
and
higher
rate
of
clotting
overwhelmed
our
typically
used
dialysis
modalities
and
dictated
quick
and
creative
problem-solving.
To
offset
these
shortages
the
“ungrateful”
nephrologists
started
to
renew
their
interest
in
using
"the
abandoned
PD"
for
AKI
treatment.
Suddenly,
PD
seemed
the
only
solution
to
manage
the
anticipated
increased
needs
for
KRT
and
the
best
option
to
rapidly
expand
the
capacity
to provide adequate and life-saving therapy.
The
"forgotten
PD"
proved
to
be
a
lifesaving
dialysis
option
and
the
only
way
to
respond
to
the
growing
demands
for
dialysis
services
even
under
“unfavourable”
conditions
such
as
bedside
catheter
placement,
prone
positioning,
and
obese
patients.
Despite
the
severity
of
the
illness
and
challenges
in
delivering PD, similar rates of death and recovery to those of AKI patients of other cohorts were reported in studies(8,9).
The
recent
pandemic
made
the
nephrology
community
reconsider
its
“ungrateful”
attitude
toward
a
dialysis
option
which
proved
to
be
lifesaving
during
this,
and
maybe
to
other,
future
natural
disasters.
PD
continuously
serves
kidney
patients'
needs
during
the
most
crucial
phases
of
their
lives:
childhood
and
elderhood
giving
them
the
chance
to
start
and
end
a
life
with
autonomy,
respect
and
dignity.
We
owe
PD
and
may
the
abovementioned
facts pave the way to a place of respect it deserves.
References:
1.
Sloan
CE,
Coffman
CJ,
Sanders
LL,
Maciejewski
ML,
Lee
SD,
Hirth
RA,
Wang
V.
Trends
in
Peritoneal
Dialysis
Use
in
the
United
States
after
Medicare Payment Reform. Clin J Am Soc Nephrol. 2019 Dec 6;14(12):1763-1772.
2.
United
States
Renal
Data
System
Annual
Data
Report
(USRDS)
Available
from:
https://www.usrds.org/annual-data-report/current-adr/
Accessed
2020 Oct 15.
3.
Van
de
Luijtgaarden
MW,
Jager
KJ,
Segelmark
M,
et
al:Trends
in
dialysis
modality
choice
and
related
patient
survival
in
the
ERA-EDTA
Registry
over a 20-year period. Nephrol Dial Transplant. 2016 Jan;31(1):120-8. doi: 10.1093/ndt/gfv295. Epub 2015 Aug 26.
4.
Bello, A.K., Okpechi, I.G., Osman, M.A. et al. Epidemiology of peritoneal dialysis outcomes. Nat Rev Nephrol 18, 779–793 (2022).
5.
ERA Registry Annual Report 2020
6.
Thamer
M,
Hwang
W,
Fink
NE,
Sadler
JH,
Wills
S,
Levin
N,
Bass
EB,
Levey
AS,
Brookmeyer
R,
Powe
NR:
US
nephrologists’
recommendation
of
dialysis modality: Results of a national survey. Am J Kidney Dis36 :1155– 1165,2000.
7.
Sabaghian, T., Kharazmi, A. B., Ansari, A., et al : (2022). COVID-19 and Acute Kidney Injury: A Systematic Review. Frontiers in Medicine, 9.
8.
Chen
W,
Caplin
N,
El
Shamy
O,
et
al
;
NYC-PD
Consortium.
Use
of
peritoneal
dialysis
for
acute
kidney
injury
during
the
COVID-19
pandemic
in
New York City: a multicenter observational study. Kidney Int. 2021 Jul;100(1):2-5.
9.
NinaJ.
Caplin,
Olga
Zhdanova,
Manish
Tandon,
et
al
.
Acute
Peritoneal
Dialysis
During
the
COVID-19
Pandemic
at
Bellevue
Hospital
in
New
York
City. Kidney360 Dec 2020, 1 (12) 1345-1352
Davide Viggiano
Professor,
University of Campania
Luigi Vanvitelli,
Naples, Italy