When did clinical nephrology begin its transformation into a science

When did clinical nephrology begin its transformation into a science?

Thomas Addis (1881–1949), a pioneer in nephrology, was one of the first clinicians to systematize the study of kidney disease, quantify the cellular (especially red blood cells) constituents of the urine sediment, use the recently developed clearance technique to determine kidney function, and introduce dietary treatment for those with kidney failure. His book, titled Glomerular Nephritis: Diagnosis and Treatment, published in 1948, remains a reference worth perusal by anyone seriously interested in the beginnings of clinical nephrology. His most famous patient was the double Nobel laureate for Chemistry and Peace, Linus Pauling (1901–1994), whom Addis treated with a protein-restricted diet. Relevant to the current debate on healthcare, it is of special interest that shortly before his death, Addis resigned from the American Medical Association in objection to its campaign against President Truman’s national plan for health insurance.

The heritage of Addis is best summed in one of his sayings, “When the patient dies the kidneys go to the pathologist, but when he lives the urine is ours. It can provide us day by day, month by month, and year by year, with a serial story of the major events going on within the kidney,” a statement that deserves to be remembered and propagated daily by every nephrologist.

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