19th century

Is it worth cross-referencing developments here, or do we just have a paragraph that alludes to the relevant page under Timeline?  To point fleetingly to some key milestones and their links to teaching centres.

• Mohammed and the discovery of blood pressure
• Bright, proteinuria, and the invention of nephrology. Followers.
• First accounts of infectious GN
• Ischuria renalis and AKI

20th century

In 1950, doctors interested in the kidney were mostly academic clinicians with an interest in physiology, who conducted long and slow studies of electrolyte and fluid balance, acid-base homeostasis, and the effects of hormones.

Apart from an early experiment with dialysis at Hammersmith Hospital, this group of clinicians were generally averse to developing the technique of dialysis. Indeed,  important work on acute renal failure at Hammersmith during and after WW2 emphasised that good outcomes could be achieved by obsessional management of fluid and electrolytes until ATN recovered [ref/links].

• Dialysis in the UK in 1959 [historyofnephrology]
• Conservative management of ARF in the 1940s [historyofnephrology]

But by the late 1950s the barriers were crumbling. The first … Parsons Leeds [links] … and in 1959-60 a slew of new dialysis operations were set up for AKI . Almost all of these were academically based, in large teaching hospitals. The need for analytical techniques, and issues with fluid and electrolyte imbalance, perhaps made it natural that it should be so. This led to intensse debate in the Renal Association, but it wasn’t until …

• [?first presentation on dialysis at RA?] [history of RA link]

In the early 1960s tentative experiments with maintaining people longer by dialysis began. A very few transplants showed signs of hope. Both techniques began to look viable

• 1961 – Threshold of the new nephrology [historyofnephrology] – first UK meeting on the topic?

At the same time as service provision grew, new discoveries in immunology led to a mushrooming of research into inflammatory renal diseases and transplantation.

• examples/ accounts

Until about 1980, growth remained centred on teaching hosptals. Consultant nephrologists were expected to have a substantial track record in research in order to be appointed to posts. But gradually the expansion in service requirements ….

1980s – expansion

The sheer numbers of patients requiring treatment led to a widespread growth in facilities and staff. Rapid expansion in consultant numbers

 

Last Updated on March 18, 2022 by neilturn