Selzman Institute of Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX.
Am J Kidney Dis. 2017 Jan;69(1):129-135. doi: 10.1053/j.ajkd.2016.06.029. Epub 2016 Oct 15.
Diseases of the kidney are old, but the discipline dedicated to their study, nephrology, is barely more than 50 years old. As recounted in this recollection of those events, the rudiments of what would become nephrology emerged in the time between the 2 World Wars from basic studies of normal kidney function and flourished after the integration of their methodologies into clinical medicine thereafter. Although shaped by studies of kidney function in the 1960s, it was the subsequent advent of dialysis that fueled the growth of nephrology well into the 21st century. Although to some extent this growth was a product of technical developments (micropuncture, dialysis, biopsy, etc), it was the paradigm shifts they engendered that brought about the revolutionary changes that stimulated the growth of nephrology from its formative years in the 1960s. Notable among those was the classification of chronic kidney disease on the basis of kidney function, calculated from serum creatinine level as estimated glomerular filtration rate, that has expanded nephrology's interaction with and integration into other disciplines and begat the recent outpouring of epidemiologic and interventional studies, thereby establishing it as a leading discipline dedicated to improving outcomes for individuals with kidney disease worldwide.
肾脏疾病由来已久，但专门研究这些疾病的学科——肾脏病学，仅有不到 50 年的历史。正如这篇回忆文章所讲述的，肾脏病学的基本原理是在两次世界大战期间从对正常肾脏功能的基础研究中产生的，并在随后将其方法学纳入临床医学后得到了发展。尽管它是在 20 世纪 60 年代对肾脏功能的研究的基础上形成的，但随后出现的透析技术为肾脏病学的发展提供了动力，使其一直延续到 21 世纪。尽管这种发展在一定程度上是技术进步（微量穿刺、透析、活检等）的产物，但正是这些技术进步带来的范式转变带来了革命性的变化，刺激了肾脏病学从 20 世纪 60 年代的形成阶段发展起来。其中值得注意的是基于血清肌酐水平估算肾小球滤过率的方法来对慢性肾脏病进行分类，这种方法扩展了肾脏病学与其他学科的相互作用和整合，并催生了最近大量的流行病学和干预研究，从而使其成为一个致力于改善全球肾脏病患者预后的主导学科。
