Nephrology had its origins in academic medical and surgical units, emerging from the 1960s onwards as dialysis and transplantation gradually became realistic approaches to renal replacement therapy for end-stage renal disease.
In the academic units resided the intellectual energy to innovate in renal care, and the human and physical resources to make dialysis and transplantation viable. Renal biopsy became a tool for renal investigation supported by academic pathologists. Research began to broaden beyond its established laboratory efforts to understand renal physiology and pathophysiology. It is unsurprising that all Renal Association presidents from the 1960s to the 1980s were professors.
Most academic renal units quickly recruited NHS consultants who were clinically focused, and there was mutual respect. The strong ethos of continuing holistic care for people with kidney disease was at the core of nephrology, and influenced recruitment. Clinical academics and NHS staff often took equal shares in clinical workload including on-call rotas. Many units consciously espoused the philosophy that there should be no distinction between the status of university and NHS-funded consultants.
Delivering research in those early years in overstretched renal units required the whole team’s commitment, lead investigators needed ‘buy-in’ from all, and senior authors were careful to ensure the ‘non-academics’ were appropriately included in research proposals and publications.
Although the UK was slow to expand clinical renal services compared to many other countries , our renal community punched above its weight in research quality, reflecting the vibrant equitable environment in most units, and the mutual respect between academic and NHS staff. By the 2020s the great majority of UK nephrologists were NHS consultants working in units away from academic centres with large clinical workloads, and little or no time for research, although the UK’s impressive record of strong recruitment into clinical trials and other clinical studies reflects continuing strong relationships between academic and other centres.
There were some other features of UK nephrology contributed to the mutual respect of academic and NHS staff
Last Updated on September 26, 2024 by John Feehally