Budapest nephrology school - 30 years of history - from modest start to an international success: systematic summary of the 27th BNS held between 28th August and 2nd of September 2023.

Budapest Nephrology School (BNS) could have celebrated its 30th event if it had not been interrupted by COVID pandemic for a few years. Yet, the organization of 27th BNS in August 2023 resumed its successful and traditional activities at Semmelweis University, in the beautiful central European city of Budapest. In over two decades, BNS has faithfully adapted to the changes and developments of medical science and clinical nephrology, the fact which has kept it unique and attractive for nephrologists from across the globe. With such a long history and representing the top international professors of nephrology, BNS has proved to be a successful one-week, in-person refreshing course which has attracted over 1600 medical doctors from more than 60 countries. It has well served as an academic meeting point suitable for networking and exchange of up-to-date knowledge presented by the best international experts in nephrology. The dedication and focus of these experts on education, research and patient care represent the very concept of translational medicine. The invaluable experience of the past 27 years has set the standards for BNS to contribute to the evolution of translational nephrology in Europe in the next decade.

[The Early Years of Nephrology at Molinette Hospital in Turin Told by Those Who Lived and Built Them].

This article, written by several authors, describes the birth and early development of the nephrology at Molinette Hospital in Torino, Italy. In particular, it supplies important information on Antonio Vercellone, very motivated and innovative clinician and one of the fathers of Italian nephrology, and on Giuseppe Piccoli, his right-hand man and then his successor. This article also shows the strong professional and human engagement that was requested to the young doctors who, in the early Sixties and Seventies of the past century, had chosen to devote their professional lives to the patients with kidney diseases: from endless workdays without schedules to the anguish caused by the shortage of artificial kidneys to the cure of very fragile and unfortunate patients, and much more.

The Mysterious Life of Jeronimus Ruscelli and His Contribution to Nephrology (1504-1566).

Jeronimo Ruscelli was a mysterious humanist of great fame. He was born in Viterbo between 1504 and 1518 and died in Venice in 1566. Very little is known about Ruscelli's life, but based on his extensive literary output we can assume that he was endowed with remarkable intellectual abilities and a propensity for varied interests. At a young age, he developed a strong interest in classical studies and attended the court of Cardinal Marini Grimani in Utini. After completing his studies at the University of Padua, he participated in the founding of a humanist academy, the Accademia degli Sdegnati (the Scornful Academy). After his fruitful experience in Rome, he moved to the Neapolitan residence of Marquis Alfonso D'Avalos. Here, Ruscelli founded an "Academy of Secrets", composed of a group of humanists and nobles who had an extensive culture and had different experiences but similar interests. During these productive years, under the pseudonym Alexius Pedemontanus, he wrote one of his masterpieces, The Secreti, an important historical documentary manual of great value. In this book, the author proposes therapies for a wide variety of diseases, claiming in most cases that they have been experimentally and successfully tested in the presence of witnesses in at least 3 clinical cases. Ruscelli composed an extensive version of The Secreti, the Secreti Novi. In this book he reported more than a thousand recipes, the substances used were of a great variety and sometimes curious. According to Ruscelli, the recipes in this updated version of the book were "easy for anyone to make, of little effort, and useful for all kinds of people." The topics of this masterpiece range from general medical suggestions to more specific indications, with a wide variety of recipes and treatments of nephrological and urological interest.

Robert Tigerstedt and the Discovery of Renin.

The year 2022 marks the 125th anniversary of the discovery of the first element of the renin-angiotensin-aldosterone system. The importance of this event on the further development of nephrology, cardiology, and endocrinology left us compelled to reminisce about it and its main author, Robert Tigerstedt (1853-1923), who was one of Scandinavia's most famous scientists. He studied medicine at the University of Helsinki, Finland. His doctoral dissertation On the Mechanical Stimulation of the Nervous System and 10 other original publications made him famous among the neurophysiological community. From 1881, he worked in the Physiology Department at Karolinska Institute, Stockholm, where he created a modern laboratory and became a professor at age 33 years. After meeting Carl Ludwig in Leipzig, he became interested in central blood circulation. In 1886, with Per Bergman, he started a series meticulously performed experiments with extracts of the rabbit kidney cortex, which, when injected into other rabbits, increased their blood pressure. The hypothetical responsible substance was called renin. The results were presented at the International Congress of Medicine in Moscow in 1887. Forty years later, Harry Goldblatt confirmed Tigerstedt's theory that "the substance which comes from kidneys increases the blood pressure." After he returned to Finland in 1901, Tigerstedt headed the Physiology Institute in Helsinki. His further activities included scientific work, teaching, and socially oriented issues like healthy nutrition and conditions in prison camps. He was also interested in the history of medicine and was a member of the Nobel Committee. His Textbook of Human Physiology was published in numerous editions in many languages. He also authored the renowned Textbook of Physiological Methodology and Physiology of Circulation. Tigerstedt published over 200 scientific papers and was an honorary doctor at many universities. He was known for his strong personality, critical judgment, idealism, humor, and warm heart.

Italian Pioneers in Cardionephrology: how some fundamental Italian cardiorenal researches have passed into oblivion.

A historical research was made on papers published by Italian scientists on cardiorenal diseases. The investigated period is between the beginning of the 20th century and the entry of Italy into the Second World War, 1940. 34 papers dealing with the relationship between the kidney and the cardiovascular system were retrieved. All but two articles were published in Italian medical periodicals. The topics covered are varied and range from cardiotoxicity of substances in uremia to the role of renal disease in vascular damage. Some articles are forerunners of later pathophysiological concepts and research technologies. These concern early atherosclerotic vascular damage and the presence of dialyzable cardiotoxic substances in renal insufficiency. Unfortunately, these highly innovative researches have had little diffusion and have fallen into oblivion in Italy and abroad. In conclusion, our research shows that in the first half of the 20th century in Italy there was a lively interest in cardio-renal diseases and that some researchers had produced precursor results of what was confirmed many years later.

[The origins of the Renal Immunopathology Group of the Italian Society of Nephrology].

This article describes the birth and development of the Renal Immunopathology Group of the Italian Society of Nephrology. It collects the stories of nephrologists and pathologists who, since the early Seventies up to the first decade of this century, devoted their professional lives to the study of renal pathology with a strong personal involvement, characterized by enthusiasm, commitment, ability, strong spirit of cooperation, and friendship. All this enabled the Group to: propose the criteria for a standardized histological and immuno-histological examination of renal biopsies and reporting; produce several multicenter studies, whose results were also published in important international journals; to set up a national registry of renal biopsies; to organize a number of courses, some of which were associated with the publication of monographs, on various renal diseases. This article also traces the history of renal pathology in Italy from the second half of the Sixties - when young Italian nephrologists and pathologists from different institutions moved to French laboratories to learn new techniques to apply to renal biopsies - up to the present days. It also shows us how Italian renal pathology has been an essential tool for the development of the nephrological clinical practice and the advancement of scientific research.

The history of peritoneal dialysis in China: past, present and future trends.

Peritoneal dialysis (PD) was introduced in China more than 60 years ago and has grown continuously since then. Now China leads the first of the world in number of patients on PD. In this manuscript a brief review of the history of peritoneal dialysis in China is presented; this includes a description of pioneers and their important contributions, discussion of peritoneal dialysate, the technique of the use of Tenckhoff catheter, the use of continuous ambulatory peritoneal dialysis (CAPD) and dialysis registration. Current ongoing PD research activities among Chinese PD academicians are also discussed. Finally, we present four areas of future focus: 1) the promotion of PD in rural areas where PD use is still very limited due to the lack of PD awareness and education; 2) PD quality management and continuous quality improvement (CQI) program particularly focusing on PD adequacy and patient rehabilitation; 3) development and enforcement of national standards on PD management; 4) multi-center studies to compare the benefits of PD and hemodialysis (HD) that should include survival, rehabilitation and cost-effectiveness.

The Future of Nephrology and Public Health.

The study of kidney diseases has been described since the Hippocratic era, but nephrology as a medical specialty dates from the mid-20th century. Despite all interesting aspects of nephrology, there is a lack of interest by young physicians for the specialty worldwide. Great discoveries have been made throughout the years, leading to great achievements in diagnosis, classification, and treatment of kidney diseases. There is a current interest in the search for novel biomarkers for early detection of kidney dysfunction, and, in the future, there will be novel diagnostic tests for kidney diseases. There have been significant improvements in dialysis and transplant techniques, and novel modalities are being studied, including new renal replacement therapy modalities, such as the wearable artificial kidney. Another trend in the contemporary world, and one that should increase in the future, is the increasing patient connectivity, using novel technologies that will allow access to healthcare and improve outcomes.

The origin of the modern Italian nephrology at the dawn of the 20th century.

The author singled out the first decade of the 20th century as the time in which the renewal of academic medicine in post-unification Italy was concluded, while the changes that would be induced by the following war had not yet started. A bibliographic research relating to this period was undertaken with the aim of investigating the number and the quality of the studies on kidneys published by Italian scientists. A total of 176 publications of Italian scientists dealing with kidney diseases or physiology was retrieved, 10.8% of which was published on foreign journals. The analysis of the topics treated shows that they were up to date and comparable with the contemporary studies across Europe. Moreover, the issues raised remained of interest throughout the following decades up to our day. Top Italian researchers were fairly cited, especially if they published on international journals. While at the time the state of other organs was mainly assessed by examining physical signs and symptoms, kidney studies required laboratory facilities. This limitation meant that kidney scholars usually belonged to well established medical faculties. From these schools, a few figures stood out among the others for the importance of their studies, both physiological and clinical in nature. The same figures also gave birth to the major Italian schools of internal medicine from which, half a century later, originated the Italian Society of Nephrology. The findings of this research support the conclusion that the basis of modern nephrology can be traced back to that decade.