"Where are all these kidney patients coming from? A few perfection the study of the urinary sediment, clinically years ago we had never heard of kidney disease and now practical kidney function tests, and the natural history of a number of kidney diseases including glomerulonephritis. you are speaking of patients in the hundreds of thousands and indeed potentially millions. " My reply, not meant to William Goldring, Herbert Chasis, Dana Atchley, and others studied the effects of hypertension, endocarditis, be grim, was "From the cemetery, Sir. " This is a summary and circulatory diseases on the kidney and spawned suc of some Congressional testimony lance gave on behalf of extending kidney disease under Medicare. Where indeed cessive generations of alert clinical investigators, who be gan to chronicle the natural histories of a wide variety of were all the patients with kidney disease in the United States before World War II? They were certainly not kidney diseases. Quantitative studies of renal function flourished under a school headed by Homer Smith, and under the care of nephrologists! Nephrology was not listed in the questionnaires for any state or the American Medi surprisingly precise techniques were developed for study ing a whole range of explicit nephron functions. Imagine cal Association as a subspecialty or even as a special the joy with the advent of vascular catheterization to be interest.

'Where are all these kidney patients coming from? A Atchley and others studied the effects of hypertension, endocarditis, and circulatory diseases on the kidney and few years ago we never heard of kidney disease and now you are speaking of patients in the hundreds of thou spawned successive generations of alert clinical investi sands and indeed potentially millions'. My reply, not gators who began to chronicle the natural histories of a meant to be grim, was 'From the cemetery, Sir'. This is wide variety of kidney diseases. Quantitative studies of a summary of some Congressional testimony I once renal function flourished under a school headed by Homer Smith, and surprisingly precise techniques were gave on behalf of extending kidney disease under Medi care. Where indeed were all the patients with kidney developed for studying a whole range of explicit nephron disease in the United States before World War II? They functions. Imagine the joy with the advent of catheteri were certainly not under the care of Nephrologists! zation to be able to apply extraction ratios and the Fick Nephrology was not listed in the questionnaires for any principle in a precise way to an organ such as the kidney State or the American Medical Association as a subspe by sampling arterial blood, venous blood and the output of the urine! One had a quantitative handle on the entire cialty or even as a special interest.

stories of postwar nephrology and metabolism. Postwar Uremia is to the nephrologist what the baby is to the nephrology rushed to the fore and supplied nephrologists pediatrician, for it is the final common pathway of literally with such wonderful tools as the flamephotometer, electro- hundreds of disease processes that lead to scarring and destruction of nephrons. . phoresis, microchemistry, immunoassay, sonography, renal biopsy, immunofluorescence, electron microscopy, and un- We estimate that there are well in excess of 300,000 clear magnetic resonance, and permitted a total integration patients in the world living on the varied methodologies of form, histologic structure, and function. Clinical represented by the three basic forms of substituted kidney nephrology became indeed the real fusion of biochemistry, function-hemodialysis, peritoneal dialysis, and renal physiology, immunology, renal endocrinology, and the transplantation: over 100,000 persons in the United States focus of newer imaging techniques. alone, well over 110,000 in the countries compromising With this precision in diagnosis, one could realistically the EDTA Registry, and over 100,000 in the Pacific Rim.