Board of the International Association for the History of Nephrology Ayse Balat – President Iwannis Stefanidis – Past President Davide Viggiano – President Elect Vincenzo Savica – Treasurer Natale G. De Santo - (ex officio) Councillors:

I am unsure whether I can express the depth of my emotions stirred by the innocent victims of the conflicts. As one of your colleagues who witnessed the human tragedy aftermath of the conflict in Syria in 2011, I would like to share my feelings. Gaziantep, where I live and work, is a province bordering Syria. The conflicts have not only pitted countries or ethnic groups against each other but have also torn apart once cohesive neighbourhoods. The victorious is unknown, but the most agonizing fact is that children and women are the victims. A myriad of people sought refuge in Türkiye. I visited children in the camps, and we followed up and treated those afflicted with kidney diseases in our clinic. Desperation, hopelessness and fear of the ambiguous future were all in their eyes. The babies born amidst that turmoil are now 12 years old... Our sole purpose is to treat our patients and sustain their lives, regardless of their religion, language or race, by adhering to the essence of the Hippocratic Oath. As we watch the distressing news reports with great sorrow, our hearts ache for all the children killed in conflict zones. With these feelings, we should always be able to raise our voices for these most innocent and vulnerable victims of conflicts and wars. Plato says, "Until philosophers are kings or the kings and princes of this world have the spirit and power of philosophy, and political greatness and wisdom meet in one, and those commoner natures who pursue either to the exclusion of the other are compelled to stand aside, cities will never have rest from their evils." As faculty members, parents, and mentors, let's hope to nurture more individuals with the spirit and power of philosophy. Sincerely yours, Prof Ayse Balat, MD President of IAHN

Presidential letter

Dear Esteemed Members of IAHN Since 2018, the IAHN Bulletin has been successfully published with the dedicated efforts of our editor, Prof Janusz Ostrowski, and the unwavering support of our esteemed members. We extend our heartfelt gratitude to everyone who has contributed to its success. Unfortunately, the year 2023 has been full of significant global challenges. In the early morning of February 6, a devastating earthquake struck Türkiye and Syria, wreaking havoc on the provinces of Hatay, Kahramanmaraş, Adıyaman, Gaziantep and Adana in Türkiye. The aftermath witnessed a tragic loss of over 50 thousand lives, leaving more than 100 thousand individuals injured. As your colleague at the centre of this earthquake, my words fail to fully express what I experienced. We had to help those who were affected by the earthquake, but we were also earthquake victims. Our tears accompanied the pain of the poor earthquake victims who were either deceased or seriously injured, unidentified, arriving at the hospital covered in dust and soil. There were losses among our students, residents, staff and their families. The saddest thing was caring for the children who had lost their families and could only be identified by assigned numbers, as their names were not even known. Amidst that anguish, moments of solace emerged when some children could open their eyes and say their names. The earthquake occurred, not known whether it is entirely over, but its effects persist. Unfortunately, the eyes of parents that lost their children or vice versa in the earthquake and the children who had an amputation due to crush injury serve as stark reminders of the tragedy… Another disaster is the continuing conflicts in the 21st century and the innocent victims of them: children! Children killed and separated from their families in Ukraine, Gaza and Israel will stand in history as a harrowing testament to our modern era.

Professor John Stewart Cameron (1934- 2023) Stewart Cameron established modern nephrology at Guy’s Hospital. London following in the footsteps of one of his heroes, Richard Bright, the 19th century Guy’s physician who was one of the first influential figures in the study of kidney disease. Cameron’s impact on Guy’s was formidable, but so much more was his influence on nephrology throughout the UK and across the world. He was one of the world’s leading nephrologists in the second half of the 20th century. His supreme gifts of intelligence, articulacy and leadership were matched by his innate modesty and his unending concern for the careers of others. John Stewart Cameron (but always known as Stewart) was born in Aberdeen, where his father was in the merchant navy, but the family moved to London in 1946 where his father worked in film production at Ealing Studios. Stewart was a gifted draughtsman (as had been his father) and for a time considered going to art school but instead decided to pursue a career in medicine. At first he planned to return to Aberdeen University to study, however differences in school qualifications between England and Scotland meant this was not straightforward, so instead he entered Guy’s in 1953. He got 1st Class Honours in an intercalated BSc in physiology, and from then on was determined to be a clinician scientist. He graduated MB BS with Distinction in 1959. Unsure at first the branch of medicine he would pursue, Professor John Butterfield at Guy’s became his mentor, and he began to study diabetes. But nephrology had grabbed his interest, not least when he read The Kidney: Structure and Function in Health and Disease (1951) by Homer Smith which was the brilliant definitive book on renal physiology at the time. Butterfield arranged for him to go to Cornell University, New York supported by a Fulbright Scholarship to work in nephrology with E Lovell ‘Stretch’ Becker and Robert F Pitts. Before he went, he and John Trounce, a clinical pharmacologist, had already established at Guy’s the beginnings of a renal unit, including dialysis for acute renal failure.

OBITUARIES

After his time in New York he was determined to make nephrology his career. He returned in 1963 as Lecturer in the Department of Medicine at Guy’s, and wrote his MD thesis on glomerular permeability to proteins in the nephrotic syndrome, based on his work at Cornell. From 1967 he was Senior Lecturer in Medicine at Guy’s, then Professor of Renal Medicine in 1974, and from 1975 Director of the Clinical Sciences Laboratories at Guy’s. He held both these positions until his retirement. This was an exciting time to be a nephrologist. People with irreversible kidney failure (a uniformly fatal condition until then) were becoming treatable; the possibility loomed of giving them even years of extra life through dialysis treatment or a kidney transplant. While in New York Cameron had seen something of these emerging techniques, but they were only just beginning in the UK, and it was clear that they were complex and demanding – both for patients and doctors. The work required practicality and passion, and could only be delivered successfully by those willing to commit their emotional and intellectual energy unstintingly. Cameron had found his metier, and from the mid-1960s he set off to establish a renal unit at Guy’s, which had been selected by the Department of Health as one of several pilot dialysis units being trialled in the UK. Recognising from the beginning that a chronic dialysis programme on its own carried the risk of unsustainable growth as more and more patients began treatment, he realised that the ideal strategy was to develop in parallel a kidney transplantation programme. He was joined by Chisholm Ogg, at first his registrar, and soon his consultant colleague. Together they built a unit which set the standards, and became well known far and wide. Collaborative teamwork was the watchword. All were partners in the kidney family – patients and staff alike. Nurses, technicians, dietitians and many others knew they were respected members of the team and responded to the responsibility and autonomy they were being given. First names were the norm, far from the tradition of the time. Such team working was innovative and unique to nephrology at the time, now it is everywhere in medicine. The work was all-consuming - their success meant patients requiring treatment for kidney failure came flooding in. They were even treating children as well as adults until Cyril Chantler joined them as a paediatric nephrologist in the early 1970s. Cameron described just how exciting it was in those early days, every day bringing a new challenge, a new opportunity - so much to learn, so much to do. They were giving it everything but there was a price. A hepatitis epidemic swept through the Guy’s renal unit in 1969, and Cameron himself was for a time severely ill with hepatitis B. But the Guy’s unit flourished and grew, many more joined the staff, and soon the unit had an international reputation, receiving visitors from all over the world. Developing the Guy’s unit would be a career high for many, but Cameron was just beginning. He was always determined that Guy’ s would be a place where research flourished alongside clinical work. He had an encyclopaedic knowledge of the whole of kidney disease, but it was in the study of glomerulonephritis, immune-mediated kidney disease, he especially made his mark. Following in the tradition of Richard Bright, Cameron recognised the importance of longitudinal study of personally observed cases as the means to understand how disease progresses. Alongside clinical observation Bright had used the best available material for laboratory study – in his case only autopsy kidneys (some of Bright’s which studied are still in the Guy’s Museum). Alongside clinical observation Cameron could use the insights now being provided by the study of kidney biopsies, as well as new serological tests, for example tests of lupus and for complement activation. He became a world leader in the study of the natural history of glomerular disease. He made outstanding contributions in glomerulonephritis, nephrotic syndrome, and lupus nephritis, as well as renal transplantation in adults and children. He was also an authority on altered urate and purine metabolism and their impact on the kidney, working with Anne Simmonds. He wrote fluently, and in the end his published output was formidable: more than 450 research papers, over a hundred book chapters, and a dozen books large and small. He was a founding editor of the Oxford Textbook of Clinical Nephrology now in its 4th Edition. And he lectured brilliantly. When Cameron went to the rostrum, he commanded your attention. He became a ubiquitous presence at national and international meetings on glomerulonephritis. If you saw his name was not on the programme, your heart sank a little because you knew that without him the meeting would generate less energy, less intellectual force, less joie de vivre. Clinician and researcher, that would be a career high for most, but Cameron still had so much more to give. Ideally suited he was soon drawn into leadership in the kidney world beyond Guy’s – becoming President not only of the Renal Association in the UK, but also of ERA-EDTA and the International Society of Nephrology. In the early 1990s he even allowed himself to be president of both the Renal Association and the ISN at the same time – an impossible workload for anyone less gifted or committed. Professor Stewart Cameron's contributions to the International Association for the History of Nephrology (IAHN) stand out significantly. For numerous years, he played a pivotal role as a distinguished authority within the organisation. Each of Professor Cameron's speeches at the IAHN Congresses garnered widespread interest, reflecting his profound influence. His written works, including a comprehensive book on the history of renal replacement therapy, further underscore his dedication to the development of the field. Actively engaging in various IAHN congresses held in locations such as Olympia in Greece, Milazzo in Italy, and Wieniec-Zdrój in Poland, Professor Cameron left an indelible mark. In recognition of his outstanding merits and substantial contributions to the advancement of nephrology's history, he was awarded the prestigious title of honorary member of IAHN during the 2013 Congress in Olympia, Greece (Figs 1, 2, 3). Beyond the IAHN platform, Professor Cameron also lent his expertise to historical sessions organised during ERA-EDTA congresses, further solidifying his commitment to fostering an understanding of nephrology's rich history (Fig. 4).

Figure 1. Professor Sándor Sonkodi, MD, DSc.

Notes on unusual uses of urine in history Urine is the end-product of kidneys, and folk science considers it just a waste fluid from our body. However, it has some physiologic function - at least in other species- and possibly some technological use. For our purposes, though, we must focus on the fact that scientists/physicians, from time to time urine have tried to find a medical virtue in it. Physiologically, urine is important, in several species to mark the territory. I am not sure if this is true also for human species: some primates use urine to mark territory (Mertl-Millhollen AS. "Olfactory demarcation of territorial boundaries by a primate--Propithecus verreauxi” Folia Primatol 1979;32(1-2):35-42), and some monkeys pee on their feet and hands (Miller et al “Why do captive tufted capuchins (Cebus apella) urine wash?” Am J Primatol. 2008 Feb;70(2):119-26); however, in modern society, the urine smell is considered unpleasant and to mark the territory with urine is considered socially unacceptable. It might not be always so: in ancient Rome urine was used to clean clothes. Everybody knows the Latrinae (toilets) in ancient Pompei, where urine could be collected, thereby used in the “fullonica” (the laundry) to wash the clothes. Aged urine (lant) has a high concentration of ammonium, which justifies this use. Therefore, I have always wondered if this means that in past times the smell of urine could be considered acceptable, in contrast to modern times. Authors even report that urine was used to whiten teeth (I have not verified the source). This reminds me of the modern use of dissolved urea to treat chronic hyponatremia, which has a very strong smell. Urine can be used as a fertilizer (because it is rich in nitrogen) and, in extreme conditions, as a source of fluids (urophagia). In the science fiction novel Dune, the Fremens, a population that lives in the deserts, wear a suit where urine is recycled so that they can drink it (somehow modern spatial programs follow a similar philosophy). Anyway, the reader should be aware that scientific societies do not support using urine as a healthy drink.

Fig. 2. Professor Stewart Cameron giving a lecture during the IAHN Congress in Milazzo, Italy, 2015 (photo. Janusz Ostrowski)

Fig. 1. Professor Stewart Cameron receiving a IAHN honorary member diploma from the IAHN President Prof. Bolesław Rutkowski. IAHN Congress in Olympia, Greece, 2013 (photo. Janusz Ostrowski)

Fig. 4. Professor Stewart Cameron during the ERA-EDTA Congress in Paris, France, 2012 (photo Maria Ostrowska)

Fig. 3. Professor Stewart Cameron (first right) during the IAHN Congress in Wieniec –Zdrój, Poland, 2017 (photo Grzegorz Główczyński)

His international leadership was not just titular, he did not sit at home directing traffic, he travelled the world teaching in many different settings, and especially encouraging the emergence of nephrology in low resource countries. With his gift for friendship and his unrelenting energy, he was a much- loved mentor to hundreds of nephrologists, many of whom came from abroad to Guy’s and then returned to their own countries. But it is more than the sum of all this work for which he should be remembered. Rather It is for the way he bore all his gifts. His complete lack of self- importance, despite his remarkable talents, his enthusiasm for the work of others, his encouragement of those many he mentored whose names and personal circumstance he never forgot – it is these for which he is most loved. Cyril Chantler described him best: ‘Stewart was the most curiously intelligent doctor I have ever known. We used to say at Guy's if you wanted to know something about anything you had to go the library……. or better still….. ask Stewart.’ Any conversation with him was a delight, a chance to learn. He was an extraordinary multilingual polymath, he read widely and voraciously. It seemed he knew more than anyone about everything - especially nephrology, and the history of nephrology. But equally about the poet John Keats (whp had been a Guy’s medical student), and rock climbing, and Gaelic poetry, and history, and wildlife , and so much more. Yet he was never grand about it, he simply loved knowledge, and loved sharing it. Unusually for those days he had married and had two children while still a medical student, a choice somewhat frowned upon at the time by the Guy’s establishment, some of whom wrongly suggested to him it might hamper his career development. Margot was a perfect foil and partner for him, and she joined him regularly on his nephrology travels. When still at the height of his powers, he was forced to retire early from clinical and academic work following complications after urgent cardiac surgery. He retired to the beautiful hill country of Cumbria in nirth west England, and though dogged subsequently by ill health he continued to write energetically across the range of his interests (including for example an extensive history of the Ross of Mull) and immersing himself in village life. When Margot developed dementia, he cared for her devotedly at home until her death. Emerging from his bereavement, he in due course found great happiness with Alison (née Russell) whom he met again forty three years after she had been a ward sister at Guy’s. Together they had written in 1971 the first book on nursing aspects of renal disease, dialysis and transplantation; they married in 2018. Stewart Cameron bestrode the world of nephrology. Once in a generation comes such a doctor whose natural gifts, intellect, energy, and modesty put them head and shoulders above us all. Greatness borne so lightly is a wonderful thing. John Stewart Cameron passed away on 30th July 2023 at the age of 89. John Feehally Janusz Ostrowski

Professor Sándor Sonkodi (1938 - 2023): Remembrance of Meetings in Košice Professor Sándor Sonkodi MD, DrSc, a distinguished Internal Medicine specialist, nephrologist, certified specialist in the treatment of hypertension and Professor Emeritus of the Internal Medicine Clinic of the University of Szeged, Hungary, former Deputy Director of the First Internal Medicine Clinic, left us for good on 4 October 2023, in the 86th year of his life. (Fig.1).

He was born in Makó (Hungary) in 1938. He graduated from the Faculty of Medicine at the University of Szeged in 1962. After graduation, he worked for one and a half years at the Department of Internal Medicine of Szentes Hospital, then he worked at the 2nd Internal Medicine Department until his retirement, and then for many years at the 1st Clinic of Internal Medicine. He was attested in internal medicine in 1967, in nephrology in 1984 and in occupational medicine in 2006. In 1990, he defended his Doctor of Medical Sciences (DSc) degree. In 1998, he was certified as a specialist in hypertension and in 2002 he became a specialist lipidologist. In 2001, he was awarded the qualification of 'clinical expert in hypertension' by the European Society of Hypertension. In 2009, he was awarded the honorary title of Professor Emeritus. From the very beginning, his scientific interest focused on nephrology and hypertension. From 1987-2008, he headed the Acute Dialysis Unit of Nephrology II. He was President of the Hungarian Society of Nephrology between 1990-1994 and member of the Hungarian Hypertension Society. Between 1996 and 1999, as a member of the European Society of Nephrology, he became a member of the ERA-EDTA Committee. He was awarded the Széchenyi Professorial Scholarship in 1999 and the Charles Simonyi Professorial Scholarship in 2000. He has been a visiting professor four times, three times in the USA, once in the UK. He has been a member of several Hungarian and international scientific societies, and also was a member of the International Association for the History of Nephrology (IAHN). He has attended some IAHN congresses. At the 1st IAHN Congress held on the island of Kos (Greece, 1996) Professor Sonkodi gave a lecture Richard Bright on Hungary: a Reevaluation (1), and at the 2nd IAHN Congress in Padua (Italy, 1998) Hypostenuria: Sandor Korányi Concept of Renal Insufficiency (2). As part of his professional political activity, he was entrusted for three years as President of the Cardiovascular Sub-programme in the National Public Health Programme since 2003. During his active clinical and scientific work, he wrote four books, 23 book chapters, and 286 scientific publications. He has given more than 500 presentations at national and international scientific forums, often as an invited speaker. He has been a speaker at the European Society of Nephrology (ERA- EDTA). The education and training of the next generation of physicians was his heart's affair and he was enthusiastically involved in undergraduate and postgraduate education. His scientific interests included blood pressure control and hypertension research. He had a special interest and positive attitude towards regular sporting activities, which was an inspiring example in his son's life. He was a member of the editorial board of eight Hungarian and three English-language scientific journals. Among his numerous Hungarian and international awards, it is important to mention that in 2005 he received "Sándor Korányi Prize of the Hungarian Society of Nephrology", of which he was the founder and proposer. In 2018, he was honoured with the award for his book History of Hungarian Nephrology (3, 4). In addition to the listed professional and scientific merits and awards of Professor Sonkodi, it is necessary to highlight his repeated invitations to the International Nephrology Symposium on "Metabolic Changes in Chronic Renal Failure”, which was organised by Professor Miroslav Mydlík in Košice. The symposia were held on the occasion of awarding the honorary degree of "Doctor Honoris Causa (Dr.h.c)" of Pavol Jozef Šafárik University in Košice to world renowned professors - nephrologists (S. Massry, J. Kopple, F. Kokot. H. Klinkmann, N. De Santo, G. Bellinghieri, V. Bonomini) or on the occasion of Professor Mydlík's jubilee. The proposal for the award of the honorary degree of Dr.h.c. was submitted by Professor Miroslav Mydlík, DrSc. On the second day after each honorary degree ceremony, the International Nephrology Symposium was held in the Historical Auditorium of the East Slovak Gallery in Košice. The total number of Symposia was 10. I will list only some of which I have pictorial documentation and the titles of Professor Sonkodi's lectures. Professor Sonkodi repeatedly visited Košice as an invited speaker at the above mentioned symposia. The Fifth International Symposium of Nephrology was held on the occasion of the award of the honorary degree of Dr.h.c. to Professor Bellinghieri (Italy) in 2000, at which Sonkodi gave a lecture on Mechanisms of Erythropoietin Causing Hypertension . The foreign participants and some invited guests visited in the afternoon the Krásna Hôrka medieval castle. International Nephrology Symposium, the 6th and 8th, was held on the occasion of the life jubilee (70th and 75th) of professor Miroslav Mydlík, MD, DSc. in 2002 ( Fig. 2) and 2007 (Fig. 3) in Košice. Among the invited speakers was again Professor Sonkodi. He gave the following lectures: Late Referral for Dialysis: the Effect on Mortality (2002) and Novel Insights into the Relationship between Lipids and Kidney Diseases (2007) . As a social programme, sightseeing tour to Betliar Manor and theatre performance Rusalka by Antonin Dvořák at the State Theatre in Košice were the highlights of the 8th Symposium. Figure 2. International Nephrology Symposium in Košice, 2002

Fig. 2b. Second part of the Symposium program

Fig. 2a. Professor Sonkodi at the lecture in the East Slovak Gallery

Fig. 2c. Social celebration of Professor Mydlik's 70th birthday)

Figure 3. International Nephrology Symposium in Košice, 2007

Fig. 3b. Visit to the Betliar Manor Professors from left: Horst Klinkmann, Miroslav Mydlík, Sándor Sonkodi Ladies from the left: Vierka Blizcová, Katka Derzsiová, Marta Knapová

Fig. 3a. Common photo of the international professors - speakers From left: Natale De Santo, Katka Derzsiová, Horst Klinkmann, Shaul Massry, Miroslav Mydlík, Guido Bellinghieri, Vincenzo Savica, Sándor Sonkodi

Fig. 3c. Horst Klinkmann and Sándor Sonkodi in front of the Betliar Manor)

Fig. 4b. Sitting in the tourist centre at Hrebienok From the left: Professors Miro Mydlík, Katka Derzsiová, Sándor Sonkodi, and Sylvia Opatrná

Fig. 4a. Visit to the Franz Kafka Memorial in Tatranské Matliare From the left: Professors Joel Kopple, Shaul Massry, Miroslav Mydlík, Guido Bellinghieri, Sándor Sonkodi

Fig. 4d. Discussion with the Mayor From the left: Guido Bellinghieri, Miroslav Mydlík, Katka Derzsiová, Sándor Sonkodi, and Joel Kopple

Fig. 4c. International guests at the Municipal Office of the Mayor of Kežmarok, Ing. Igor Šajtlavý From left: professors: Joel Kopple, Sándor Sonkodi, Katka Derzsiová, Miroslav Mydlík, Guido Bellinghieri, and Shaul Massry

Fig. 4e. Mayor of Kežmarok, Ing. Igor Šajtlava

Fig. 5a. Social gathering at the end of the Symposium in the Tokaj cellar From the left: Professor Horst Klinkmann, Dipl. Ing. Katka Derzsiová, Professor Sándor Sonkodi

Fig. 5c. Professor Sándor Sonkodi in the Tokaj celler

Fig. 5b. Social dinner in the restaurant From left: Professor Vincenzo Savica, Professor Sándor Sonkodi, Dr.Ervin Klecka, Professor Horst Klinkmann

In May 2020, we were preparing the 11th Symposium in memory of Professor Miroslav Mydlík (1932 -2018). The Symposium did not take place due to the Covid pandemic. A schedule was prepared which consisted of 16 lectures by eminent international and national nephrologists. Professor Sonkodi submitted a lecture on Cardiovascular and Renal Outcomes of Diabetic Nephropathy. Apart from the International Nephrology Symposia, Sonkodi also participated in the 6th Franz Kafka Memorial, which was held on the occasion of the 10th anniversary of the unveiling of his memorial in Tatranské Matliare, in the High Tatras, 2011. In his lecture Franz Kafka and Robert Klopstock in Hungary , he discussed the relationship between Franz Kafka and Robert Klopstock, a medical student from Dombovár (Hungary). Robert Klopstock was treated for lung tuberculosis together with Franz Kafka in the Tatranské Matliare and became his last friend. He was also at his deathbed. Professor Mydlík considered Sándor Sonkodi to be a close friend, an excellent nephrologist from a country neighbouring Slovakia, as evidenced by his repeated visits to Slovakia, especially to Košice. In addition, his native language was not unknown to us, as we both spoke Hungarian. The memory of Professor Sándor Sonkodi, MD, DSc., as a true friend who was always happy to come to Košice, will always remain in my memory. Honour to his memory. Dipl. Ing. Katka Derzsiová References 1. Nagy Judit, Sonkodi S. Richard Bright in Hungary: A Reevaluation Am J Nephrol 1997; 17 (3, 4): 287-291. 2. Sonkodi S. Hypostenuria: Sandor Koranyi Concept of Renal InsufficiencyAm J Nephrol 1999; 19(2): 320-322 3. Sonkodi Sándor – Wikipédia https://hu.wikipedia.org/wiki/Sonkodi_Sándor 4. Szegedi Tudományegyetem https://www.med.u-szeged.hu/hirek/2023-oktober/elhunyt-dr-sonkodi-231005 Professor Eberhardt Ritz (1938-2023) Born on January 23, 1938, in Heidelberg, Germany, Professor Eberhard Ritz, embarked on his academic journey in 1957 studying medicine until 1963 at universities in Heidelberg and Munich in Germany, Montpelier in France, and Rome in Italy. His pursuit of knowledge extended to the United States, where he held a scholarship at the Department of Biochemistry, University of Washington in St. Louis, from 1966 to 1967. Returning to Heidelberg in 1967, Professor Ritz dedicated himself to Ruperto Carola University. In 1970, he assumed the role of Head of the Nephrology Department at the Internal Medicine Clinic, a position he held until his retirement in 2003. His academic achievements include a doctorate from the University of Heidelberg in 1963 and the completion of his habilitation in 1972, based on the thesis, Renal Osteodystrophy in Dialysed Patients . In recognition of his contributions, he was conferred with the title of professor in 1974 (Fig. 1). Professor E. Ritz made remarkable and diverse scientific contributions throughout his career. His extensive body of work includes groundbreaking research on hypertension, diabetic nephropathy, multicystic kidney degeneration, cardiovascular complications in chronic renal failure patients, and the metabolic and physiological effects of haemodialysis. A trailblazer in his field, Professor Ritz played a pivotal role in pioneering the use of angiotensin-converting enzyme inhibitors to halt the progression of renal failure, particularly in cases of diabetic kidney disease. Additionally, his investigations into the metabolic effects of vitamin D3 have significantly advanced our understanding of its physiological impact. Over the span of five decades dedicated to his profession, Professor Ritz authored or co-authored nearly 1,500 scientific papers published in some of the most esteemed medical journals. Even in retirement, his commitment to scientific pursuits remained unwavering, consistently contributing an impressive average of 40-50 papers annually. Noteworthy among his accomplishments is a significant educational initiative – the Seminars in Nephrology and Hypertension – held in his hometown since 1976. These seminars, attracting over 700 participants from across the globe each year, reflect his enduring impact. Professor E. Ritz was distinguished not only for his prolific writing but also for his captivating lectures that invariably left an indelible mark. As a visiting professor, he delivered enlightening talks in numerous countries worldwide, showcasing his linguistic versatility. Fluent in English, French, Italian, Russian, and Polish, he captivated audiences, as demonstrated during nephrology meetings in Katowice. I am delighted to highlight Professor E. Ritz’s remarkable involvement in shaping the landscape of nephrology, particularly through his invaluable contributions to the European Renal Association-European Dialysis and Transplant Association (ERA–EDTA). From 1990 to 1993, he served as a member of the ERA–EDTA Management Board. In 2003, he took the helm as the President of the World Congress of Nephrology held in Berlin, showcasing his leadership and dedication to the global nephrology community. In recognition of his outstanding achievements, Prof. E. Ritz was honoured with the title of Honorary Member of ERA–EDTA during the 2005 awards ceremony in Istanbul. His influence and impact on European and world nephrology were further acknowledged during the 48th ERA–EDTA Congress in Prague in 2011, where he received the prestigious ERA–EDTA award. The laudation, a testament to his significant contributions, was eloquently delivered by his close colleague, Prof. Andrzej Więcek. Prof. E. Ritz's commitment to advancing nephrology extends beyond organisational roles. From 1993 to 1999, he served as the Editor-in-Chief of the official journal of ERA–EDTA, Nephrology, Dialysis, Transplantation. Additionally, his expertise was recognised globally, as he contributed to the editorial boards of esteemed journals, including Kidney International, Nephron, Journal of the American Society of Nephrology, American Journal of Kidney Diseases, Klinische Wochenschrift, and Clinical Nephrology. Further underscoring his international standing, Prof. E. Ritz assumed the role of President of the International Society of Nephrology (ISN) from 2007 to 2009 (Fig. 2). Professor E. Ritz played a crucial role in advancing nephrology in Central and Eastern European countries. Notably, he was instrumental in organising annual postgraduate training courses in Prague since 2001. His significant impact is particularly evident in the education of a substantial number of nephrologists from Poland. Professor E. Ritz was an active participant in the Katowice Seminars on "Advances in Nephrology and Hypertension" from 2001 to 2014, where he served as a member of the Scientific Committee. In recognition of his exceptional scientific accomplishments, Professor E. Ritz received numerous honorary doctorates, notably from the Silesian Medical Academy in Katowice in 1991 (with the title proposed by Professor Franciszek Kokot), the Pomeranian Medical Academy (PAM) in Szczecin, the Sommelweis University in Budapest, Hungary, and the Gr. T. Poppa University of Medicine and Pharmacy in Iasi, Romania (2012). Professor E. Ritz was honoured as an esteemed member in various national societies of nephrology, attaining the distinguished title of honorary member in Poland, the Czech Republic, Slovakia, Hungary, Romania, France, Italy, Australia, Spain, and South Africa. Over the past 25 years, he was also the recipient of numerous prestigious awards. Among these accolades are the "Bundesverdienstkreuz" from the German government, the Volhard Medal, the Langerhans Award from the German Diabetes Association, the Zanchetti Award from the European Society of Hypertension, the Pasteur Medal (University of Strasbourg), the Malpighi Medal (University of Bologna), the Jacob Henle Medal (University of Göttingen), the John Peters Award from the American Society of Nephrology, the Scribner Award from the International Society of Haemodialysis, the Distinguished Investigator Medal from the National Kidney Foundation, and the Jean Hamburger Medal from the International Society of Nephrology. Professor E. Ritz was also an honorary member of the American College of Physicians, the Royal College of Physicians in London and Edinburgh, and the Societas Medica Chirurgica in Bologna, Italy. Professor Eberhard Ritz died on October 29, 2023 following a serious illness. As we mourn the loss of this esteemed figure, we take solace in the enduring impact of his work and the indelible mark he left on nephrology. Professor Eberhard Ritz will be fondly remembered, his influence resonating in the memories of those fortunate enough to have crossed paths with him. Janusz Ostrowski Bolesłąw Rutkowski Andrzej Więcek

A Century After The First Peritoneal Dialysis Treatment 1 Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy. This year marks the 100th anniversary of the first peritoneal dialysis treatment. This represents undoubtedly a milestone in the history of nephrology and an important reminder of where we were with the efficiency of renal replacement therapy and where we are today. In fact, Georg Ganter performed peritoneal dialysis for the first time in 1923 by instilling and then draining hypertonic saline in two cases of renal failure and reported his results in the paper «Ueber die Beseitigung giftiger Stoffe aus dem Blute durch Dialyse» («About the removal of toxic substances from the blood by dialysis»). Dr Ganter studied in Freiberg, Munich, Greiswald and Wurzburg where he worked on peritoneal dialysis, and he became Professor of Internal Medicine in Rostock . He reported on the results of studies on rabbits and guinea pigs suffering from uraemia due to obstruction of their ureters. He discovered that the administration of saline solution via the peritoneum alleviated the symptoms of uraemia and lowered the urea nitrogen in the blood. To carry out the fluid exchange, he used implanted drainage tubes in the peritoneal cavity and introduced saline solutions in quantities of about 50 ml, which remained in the peritoneal cavity for about 3 hours. After this time, the fluid was aspirated, resulting in an average volume of 10–30 ml. The technique

was then repeated up to four times. He found that after each interaction there was an almost complete equilibrium of non-protein nitrogen between the dialysate and blood concentrations and that some of the introduced fluid was assimilated. He also observed a positive change in the uraemic symptoms of the animals after peritoneal lavage. Ganter applied this technique to a patient suffering from acute uraemia caused by bilateral ureteral obstruction due to uterine cancer. The patient's condition improved temporarily after a single intraperitoneal infusion of 1.5 litres of physiological saline. In another case involving coma caused by diabetic ketoacidosis, the doctor administered 3 litres of saline directly into the abdominal cavity. As a result, the patient's mental state temporarily improved. Although his clinical experience with intermittent peritoneal dialysis was limited, he believed that this procedure had the potential to become a new therapy. He identified several key factors that were critical to the effectiveness of the procedure: Ensuring proper access for fluid flow, preventing peritoneal infections by using sterile solutions, using a sufficient amount of dialysate to remove uraemic toxins. In addition, he suggested the use of hypertonic solutions to facilitate the elimination of fluids and toxins. Few years later, in 1926, Rosenak, a researcher from Budapest, and Siwon, a member of the surgical department at the University of Bonn in Germany, conducted a series of studies on continuous peritoneal dialysis in nephrectomized dogs. The tip of the inflow cannula was positioned below the liver, while the outflow cannula was placed in the Douglas cavity . In 1934, Balazs and Rosenak of St Rochus Hospital in Budapest, Hungary, performed the first uninterrupted peritoneal dialysis procedures on two patients suffering from severe renal failure due to mercury bichloride poisoning . The first patient underwent 30 minutes of continuous dialysis, receiving 12 litres of 4.2% glucose. In contrast, the second patient received 19 litres of 0.8% saline during a continuous dialysis session of 1.5 hours. Both patients died. In 1937, Wear, Sisk and Trinkle from Wisconsin General Hospital in Madison, Wisconsin, USA, reported the first documented example of a patient who successfully survived after peritoneal lavage for the treatment of uraemia . They performed the above method on five patients, but only one survived. In 1946, Howard Frank, Arnold Seligman, and Jacob Fine from Beth Israel Hospital in Boston documented the initial effective application of peritoneal dialysis in a clinical setting. This treatment was administered to a 51-year-old male patient suffering from acute renal failure as a result of sulfathiazole poisoning . The advantage of peritoneal dialysis over typical conservative or supportive treatment of acute renal failure became clear in the 1950s and 1960s when researchers such as Maxwell, Grollman and Roberts modified the catheter and improved insertion procedures . In 1968, researchers Henry Tenckhoff and H. Schechter from the University of Washington in Seattle, Washington, USA, presented the results of their investigations on a new type of catheter . The Tenckhoff catheter is now widely recognised as the most reliable and widely accepted method for accessing the abdominal cavity. Twardowski has presented a comprehensive overview of the Tenckhoff catheter and the evolution of peritoneal dialysis catheters throughout the past century. This work is considered a significant milestone in the history of peritoneal dialysis and should be acknowledged by all professionals and practitioners in this field . Years after these significant step forwards in peritoneal dialysis, there have been several advances in the development of new dialysis solutions and techniques to enhance the efficiency and effectiveness of peritoneal dialysis. Today, peritoneal dialysis remains an important modality for renal replacement therapy, offering patients an alternative to hemodialysis and an effective bridge to renal transplantation. It provides the flexibility of home-based treatment, allowing individuals to have more control over their dialysis schedule and lifestyle. Guido Gembillo References: 1. Ganter G. Ueber die Beseitigung giftiger Stoffe aus demBlute durch Dialyse (On the elimination of toxic substances from the blood by dialysis). Münch Med Wochenschr 1923; 70: 1478-80. 2. Rosenak S, Siwon P. Experimentelle Untersuchungen über die peritoneale Ausscheidung harnpflichtiger Substanzen aus dem Blute (Experimental investigations on the peritoneal eliminationfrom the blood of substances normally excreted in urine). Mitteilungen aus den Grenzgebieten der Medizin und Chirurgie 1926; 39: 391-408. 3. Balazs J, Rosenak S. Zur Behandlung der Sublimatanurie durch peritoneale Dialyse (On the treatment of anuria caused by mercury bichloride with peritoneal dialysis). Wien Klin Wochenschr 1934;47:851-4. 4. Wear JB, Sisk IR, Trinkle AJ. Peritoneal lavage in the treatment of uremia. J Urol 1938; 39: 53-62. 5. Frank Ha, Seligman Am, Fine J. Treatment Of Uremia After Acute Renal Failure By Peritoneal Irrigation. Jama. 1946;130(11):703–705. Doi:10.1001/Jama.1946.02870110027008a 6. McBride P. Morton Maxwell: he made acute peritoneal dialysis a routine procedure. Perit Dial Int 1984; 4: 58–59. 7. Tenckhoff H, Schechter H. A bacteriologically safe peritoneal access device. Trans Am Soc Artif Intern Organs 1968; 14: 181-7. 8. Twardowski ZJ. History of peritoneal access development. Int J Artif Organs. 2006 Jan;29(1):2-40. doi: 10.1177/039139880602900102. PMID: 16485237.

Fig. 1. Prof. Janusz Ostrowski while chairing a scientific session (photo. Maria Ostrowska).

Fig. 2. Left first: prof. Ryszard Gellert, prof. Janusz Ostrowski (photo. Maria Ostrowska).

Fig 3. Prof. Janusz Ostrowski presenting his lecture (photo. Przemysław Rutkowski)

Fig. 4. Prof. Przemysław Rutkowski presenting his lecture (photo. Janusz Ostrowski)

INFORMATION ABOUT NEXT IAHN CONGRESS Announcement: XIII IAHN Meeting, Naples We are pleased to inform you that the next Meeting of the International Association for the History of Nephrology will be held in Naples from September 17th to 19th, 2024. The International Association of Nephrology (IAHN) will celebrate the XIII Congress in Italy, where all started in 1993. In thirty years, a critical mass of data has been collected, representing the backbone of five hundred original manuscripts appearing in international journals. The Congress aims to celebrate the progress of a discipline that developed in the boundary zones of other disciplines and entered the scientific parlance in the 50s of the twentieth century. It is a young discipline fueled by the advent of dialysis. However, it existed well before Thomas Addis. The discipline rapidly progresses to meet the needs and expectations of 10 % of the world population. The 2024 IAHN meeting will pay attention to treatments of kidney diseases from antiquity to the present: this will allow to better understand the latest therapeutical advances (such as HIF inhibitors, MCO filters, glyflozins, new mineralocorticoid antagonists, new CNI, anti-Bliss etc) from a historical perspective, motivating new historical studies and a better understanding of today's treatments. We are working on celebrating the History of Nephrology in one of the oldest Scientific academics in Italy, characterized by an exciting scientific program complemented by poster sessions, with numerous opportunities to connect face-to-face with prestigious Italian and foreign researchers in the History of nephrology. The Plenary Lectures, held by Italian and international researchers, will favor the direct involvement of young scientists. We are excited to bring the community together in 2024 to debate over research and develop new research ideas. Why attend? Attending the 2024 IAHN meeting is crucial for anyone interested in the history of Nephrology and for the physician and the scientist who needs to gather a better perspective of today's scientific knowledge, how we arrived where we are, and which false paths slowed scientific progression. Preliminary information. Venue: Società di Scienze Lettere e Arti, Via Mezzocannone 8, 80134, Naples, Italy Faculty: Congress fee: free for IAHN members Scientific secretary: for information email to davide.viggiano@unicampania.it Abstract submission: start 1 December 2023, deadline: 1 May 2024

Figure 1. Professor Eberhard Ritz during the 48th ERA-EDTA Congress in Prague in 2011 (photo Janusz Ostrowski)

Figure 2. Professor Eberhard Ritz during the Katowice Seminar in 2013.