Nephrology | Hektoen International

A fatal and mysterious illness

Michael D. Shulman Philadelphia, Pennsylvania, United States      Scans, like  those above, showing reflux and stasis of cerebrospinal fluid (CSF) in patients with dialysis dementia prompted placement of a CSF shunt in at least one patient before intriguing new diagnostic clues emerged. In late 1972, a flurry of letters began to appear in the […]

Robert M. Kark (1911-2002)

In the 1950’s, Robert Kark and his team of Robert C Muehrcke, Victor Pollak, and Conrad Pirani became, for a short time, the dominant force in American nephrology by popularizing the use of kidney biopsy as a diagnostic tool. This technique had first been described by Scandinavian investigators with somewhat limited success, but the Kark team […]

Death from uremia

“Your grandmother is doomed,” [the doctor] said to me. “It is a stroke brought on by uremia. In itself, uremia is not necessarily fatal, but this case seems to me hopeless. I need not tell you that I hope I am mistaken.” [Then] there was a moment when the uremic trouble affected her eyes. For […]

Dr. Willem J. Kolff: a great man

In Memoriam Willem J. Kolff: A great man George DUNEA President and CEO, Hektoen Institute of Medicine, Professor of Medicine, University of Illinois at Chicago, Medical Director, Chicago Dialysis Center, Founding Chairman Emeritus, Division of Nephrology, Stroger Hospital of Cook County, Chicago, IL (Spring 2015)   Willem Kolff, often called the father of the artificial […]

The village uroscopist

Alexandru Gh. Sonoc Sibiu, Romania     The Village Physician David Teniers the Younger (1610-1690) Brukenthal National Museum, Sibiu, Romania   A physician sits in his studio at a table on which stand several covered vases. He has a book in his left hand and holds in his right hand a glass flask against the […]

Nephrology in 10 Steps

Andrew S. Bomback New York, United States     Photography by COMSALUD 1 I was seeing patients in clinic the morning my daughter was born. My wife called me to say that her contractions, relatively weak and infrequent when I had left home a few hours earlier, had suddenly picked up. She asked how quickly […]

History of nephrology: beginnings

George Dunea Chicago, Illinois, United States   Introduction In the second half of the 20th century nephrology became a fully-fledged specialty owing largely to the development of renal biopsy, dialysis, and kidney transplantation.1 Yet the seeds of these great advances were sown centuries earlier, based on the work and observations of scientists and clinicians dating […]

History of nephrology: the middle period

George Dunea Chicago, Illinois, United States   Domenico Cotugno Coagulable urine Despite centuries of medical progress, the presence of abnormal amounts of albumin in the urine remains to this day the most sensitive and widely used indicator of renal disease. Described by Hippocrates as “bubbles on the surface of the urine” and known to medieval […]

History of nephrology: modern era

George Dunea Chicago, Illinois, United States   Twentieth century Three major developments—renal biopsy, dialysis, and transplantation—revolutionized nephrology in the second half of the 20th century. Renal biopsy transformed the diagnostic approach to renal disease from a clinical methodology to one based on morphological analysis. Presently over one million patients with renal failure are maintained by […]

Domenico Cotugno (1736-1822)

Domenico Cotugno During a period of over 40 years Domenico Cotugno served as professor of anatomy at the University of Naples, one of the oldest institutions of higher learning in the world, founded by the Holy Roman Emperor Frederic II in 1224. His academic career was marked by several important advances for which he is […]