As we come to the end of the naughts, we naturally reflect back and think about how far we have come from in the last ten years. Here is my quick list:
- MYH9 gene for ESRD
- The failure of the normalization of hemoglobin and the wholesale reevaluation of ESAs
- The rise of aldosterone and its importance in hypertension and renal disease
- the failure of dialysis dose to improve out come in both chronic (HEMO) and acute dialysis (ATN).
- FGF-23, hey a whole new hormone and a major advancement in renal physiology
- Re-emergence of home dialysis
- Problems with the definition of CKD and the problems with eGFR
- discovering the antigen in idiopathic membranous nephropathy
I want to do a longer article about this but I’m sure I’m missing some stuff. I don’t have a transplant subject, seems like vitamin D belongs up there, what about the phos binder wars? Bundling? What about MMF in lupus nephritis and every other GN?
And antibodies against Lamp-2 in ANCA associated GN.
But the top story is the function of primary cilia in polycystic kidney diseases. The rediscovery of primary cilia is really amazing and very important in nephrology and in biology.
So for me it's clearly the top story
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The massive epidemiologic studies that cemented CKD as a fully independent cardiovascular risk factor and the emergence of NSF.
For your transplant story, I suggest the recognition of the significance of antibody-mediated rejection.
Nice list. I would add primary cilia's role in cystic kidney disease as well as the increasing recognition that CKD/ESRD is a huge risk factor for CV mortality.
An interesting follow-up question would be: What are the major unanswered questions in Nephrology? Just off the top of my head, "What role do stem cells play in kidney development and repair?", "How can we improve the mortality rate in ICU-associated AKI?", and "What is the circulating factor responsible for FSGS?" are obvious possibilities.