ISN NEWS


ISN NEWS

S p r i n g / S u m m e r I s s u e
  •   2 0 0 0

AN OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY
OF NEPHROLOGY


 

Editor
Andrew J. Rees, MD
University of Aberdeen
Aberdeen, Scotland, United Kingdom

Contents

Message from the President – Thomas Andreoli, MD

Preliminary
Report of Actions of the ISN Renal Disaster Relief Task Force
– European Branch –
Norbert Lameire, MD

ISN Fellowship Program – Rashad Barsoum, MD, FRCP,
FRCPE

XV
International Congress of Nephrology and XI Latin American Congress of Nephrology

Elvira Arrizurieta, MD

Commission
on the History of Nephrology, the Archives of the ISN and the Video Legacy Project

Kim Solez, MD

Will being Wired Signal
the End of the Papyrocentric Era?
–  Saulo Klahr, MD

Reports from the Regions ? – Michael Field, MD

Coming
Soon


 


Message from the President

Thomas E. Andreoli, MD

It is a particular pleasure for me to announce, by way of this message,
that the International Society of Nephrology will publish a Newsletter twice yearly under
the aegis of Andy Rees. The idea was originally the brainchild of Jan Weening who has
served our Society as Associate Editor of Kidney International, as
Past-Secretary-General and currently as Vice-President. As one reflects on our Society, it
has come a rather longer way than our founders might have envisioned in 1960.

At the time, the cardinal intents of the Society were to sponsor an
international meeting and to publish a journal. The International Congresses have been a
brilliant success. During Ike Robinson’s tenure as President, 1990—1993, the
format of the ISN Congresses was changed in two respects: the ISN Congress focused, since
Ike initiated the change, on a series of thematic presentations of benefit to world
nephrology; and since 1993, the Congresses have been held every second year instead of
every third year. In 2001, the ISN will hold its first joint meeting with the American
Society of Nephrology; in 2003, the Congress will be held in Berlin in conjunction with
the European Renal Association.

Kidney International began in 1972 with Ike Robinson serving as a
splendid Editor. Saulo Klahr, our Editor-in-Chief, has elevated Kidney International
to the leading nephrology journal in the world community.

In addition to these activities, the ISN has initiated many other
programs. Some of our more successful programs include: the Renal Sister Center Program,
developed by Robert Schrier during his Presidency; the ISN Fellowship Program; the
Forefronts in Nephrology series, conducted first by Gerhard Giebisch and now by Robert
Alpern and Heini Murer; and COMGAN, the Committee for the Global Advancement of
Nephrology, which, under the direction of Barry Brenner and John Dirks, has brought
Nephrology to nearly all parts of the globe.

The major goals of the ISN, coincident with the beginning of the
millennium, are manifold.

First and foremost among these is the intent of the Executive Committee
and the Council to insure that regions of the world that account for more two-thirds of
the world’s population–especially China, India, Central and Eastern Europe and
South America–have a greater voice in the activities of the Society. In other words,
we wish to make ISN a truly international Society.

Second, Saulo Klahr and his Co-Editors of Kidney International are
now at work on electronic dissemination of Kidney International. Our hope is that Kidney
International
will be on-line for virtually everyone on the globe. Currently, our
system of Joint Membership, which allows a number of individuals to share in a
subscription to Kidney International, has gone a long way toward disseminating
scientific knowledge in nephrology throughout the globe. But we wish an even greate r
sense of participation by the world renal community.

Third, the Commission on Acute Renal Failure, under the able direction
of Norbert Lameire, has already shown its ability to be of great help in calamities such
as the earthquakes in Turkey and the recent tragedy in Kosovo. One hopes that ISN will be
able to extend its activities in dealing with outbreaks of acute renal failure or, for
that matter, other epidemic outbreaks of renal disease, in similar ways.

Fourth, the Commission on Informatics, under the direction of Kim
Solez, is working diligently to extend the communications network of ISN globally.

Fifth, I am delighted to announce that, due largely to Jan
Weening’s efforts, there will be a permanent Archives for the ISN housed in Amsterdam
which contains matters of historical importance to our Society.

Lastly, it is quite likely that the number of members of the Executive
Committee will be increased, with the explicit intent of enhancing participation by
nephrologists from all over the globe in the activities of ISN. Moreover, the Executive
Committee will now hold annual retreats. These two factors, that is, an increased number
of members of the Executive Committee and annual retreats, should allow an increasingly
global participation in the activities of ISN.

It is a privilege for me to serve as President. More importantly, I
wish to express publicly my gratitude to the members of the Executive Committee, past and
present, and to the past and present members of the Council who have been responsible for
the dramatic successes of our Society between 1960 and the present. I am sure that this
Newsletter, under Andy Rees’ direction, will be equally successful.
 isn


Thomas Andreoli is President of the ISN and past Editor of Kidney International.


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Preliminary
Report of Actions of the International Society of Nephrology Renal Disaster Relief Task
Force–European Branch

Norbert Lameire, MD

During the past year our world has been shocked by a series of natural
and political disas-ters causing thousands of casualties and many more wounded. Because of
the high incidence of acute renal failure, the European Task Force of the ISN Commission
on Acute Renal Failure led by Dr. Norbert Lameire from Gent, Belgium, has been called into
action several times. Here is the report on their actions in Moldova, Macedonia, Kosovo,
Turkey, Greece, Taiwan and Mexico.

Moldova

On Friday, March 13th 1999, the Task Force was informed that the
dialysis units in Moldova were no longer receiving financial support from their government
to pay for the supplies of equipment for dialysis. This information was provided by Prof.
A. Fournier, who has a ISN renal sister program with the unit of Prof. Tanasa in Chisinau,
Moldova. After contacts with several companies, the Task Force was able to collect goods
and transport them, via Schiphol, Amsterdam to Chisinau, Moldova with Moldova Airlines. A
detailed report has been distributed to the ISN/ARF members, the ISN Executive Board and
COMGAN. The intervention was terminated April 1999 and according to our information, the
government revised their decision and is again supporting the dialysis units.

Macedonia

In late April 1999, the European Task Force was approached for help by
the United Nations High Commissariat for Refugees in the former Yugoslavian Republic of
Macedonia, which was responsible for the refugees from Kosovo. Among thousands of
refugees, numerous chronic hemodialysis patients who were treated in Pristina and other
dialysis centers in Kosovo had to be admitted to the Macedonian dialysis centers for
urgent dialysis. The Macedonian centers could not cope with this unexpectedly high number
of new patients and were asking for urgent evacuation of some of them to other European
countries. Thanks to the Task Force organization, immediate requests for help were sent to
key persons in different West European countries and their governments.

Several days of negotiation followed, which ultimately led to the
evacuation of dialysis patients and their families to Belgium, Sweden, The Netherlands and
France. Arrangements for more patients to be received in Sweden, Denmark and the United
Kingdom were made. The German Kuratorium f�r Dialyse und Niertransplantation (Secretary
M. Molzahn), also offered to accept an additional 10—20 patients and their families
in Germany.

Many dialysis patients who emigrated to Albania were admitted to
Italian dialysis centers. The Task Force had excellent cooperation from important dialysis
companies and Baxter Europe is a permanent partner of the European Branch. Furthermore, an
important quantity of hemodialysis equipment was urgently sent to Skopje by Fresenius, and
impressive quantities of peritoneal dialysis equipment, including dialysis fluid, was
provided to Macedonia by Baxter.

An extremely good rapport was established between the Task Force in
Gent and the UNHCR representative, Dr. Burkholder, in Macedonia. Cooperation between the
Task Force and our industry partner was similarly excellent.

Kosovo

On June 24, 1999 the Task Force received a phone call from Dr. Marco
R�edi, Medical Coordinator, UNHCR, Skopje, and successor of Dr. Burkholder, asking the
Task Force to arrange site visits to Skopje, Struga in Macedonia, and eventually to
dialysis centers in Kosovo. The purpose was to evaluate the needs for dialysis help in the
Macedonian and Kosovo dialysis centers.

The Task Force sent two nephrologists, Dr. N. Veys and Dr. J. Clement,
to Macedonia and Kosovo from June 30 till July 4 1999.

They visited units in Macedonia and Kosovo, with Dr. R�edi who
formally requested the Task Force to help with very urgent needs for dialysis material and
equipment. The most urgent needs were gasoline, industrial salt for decalcification of the
water, dialysis membranes, vitamin D and erythropoietin. Dr. R�edi was provided with an
official letter from the ISN which allowed him to request that gasoline be delivered
urgently to the dialysis units. The supply started within two days.

Contacts were made between the Task Force, Medecin Sans Frontieres
(MSF), and with several dialysis companies. Fresenius delivered 14 dialysis machines and
1000 membranes, in cooperation with the German Kuratorium f�r Hemodialyse. They continued
to deliver supplies during the war, in cooperation with their distributor in Belgrade.
They also continued deliveries to dialysis units in Kosovo after the war. Solvay Belgium
donated 10 tons of industrial salt and Birkart Logistics took care of the transport.
Unfortunately, the pharmaceutical products from Roche could not be delivered for reasons
of safety.

In the meantime contacts were established with COMGAN and Prof. E.
Ritz, to organize a training course for dialysis nurses in Kosovo.

Turkey

A massive earthquake in northwestern Turkey, the densely populated
industrial heartland of the country occurred at 3.02 a.m. on Tuesday August 17, 1999.

Our scouting nephrologist, R. Vanholder, arrived in Istanbul with the
first team of MSF in the evening of August 17, and it was already clear that, besides
thousands of deaths, many of the victims had crush syndromes, complicated by
rhabdomyolysis and ARF could be expected. A second nephrologist, B. Van Vlem, together
with 5 Flemish dialysis nurses from ORPADT, left for Istanbul with a second team of MSF on
the second day. In the meantime, R. Vanholder was helping the local Turkish nephrologists
to organize the dialysis help in the major University Hospitals in Marmara, Cerrahpa�a,
and �apa.

Our nephrologists were instrumental in instructing medical teams of MSF
and other rescue workers in the early administration of fluid therapy for prevention of
ARF.

It was decided to transfer chronic dialysis patients to private centers
who had less experience with ARF patients and so make room for the ARF patients in the
public University Hospitals in Istanbul and other cities.

In Gent, a first shipment of dialysis concentrate, hemodialysis and
peritoneal dialysis catheters, membranes and other equipment was organized with the help
of the local University Hospital pharmacy, MSF, the Belgian Air Force, and the European
and Belgian divisions of Fresenius and Baxter.

Thanks to the incredible efforts of the Turkish nephrologists and
dialysis nurses and with the great help of Dr. Ersoy from Antalya, it was possible to
collect correct information on the number of dialysed ARF patients almost immediately, not
only in Istanbul but other cities like Ankara, Bursa, and Eski�ehir.

On Friday August 27, after consultation with Prof Erek, President of
the Turkish Society of Nephrology, the Task Force appointed a distinguished Turkish
colleague, Prof Sever from the �apa University Hospital, to be local ISN/Renal Disaster
Task Force representative. At that time, approximately 395 patients were on dialysis for
post-traumatic ARF in the whole disaster area, 14 patients had recovered renal function
and 42 had died. It was agreed that as far as was possible, an accurate registering of the
number of patients and their follow up should be attempted in a combined effort between
the ISN and the Turkish Society of Nephrology.

At the end of the first week, a second team arrived in Istanbul which
consisted of Swedish dialysis nurses working together with two other young nephrologists
from Gent, Heidi Hoeben and Wim Van Biesen. In view of the extreme efforts of the Turkish
nurses who worked day and night, it became apparent that a third and fourth team was
needed in both Istanbul and Bursa to allow them some rest. A team of 5 German nurses and
one German nephrologist, Dr. Schindler from Berlin left for Istanbul while another team of
Flemish, French, and English nurses helped in Bursa.

A complete French team of 7 nurses, together with a French
nephrologist, Dr. D. Erbilgin, replaced the Task Force team in Bursa at the end of August.

In the week of September 20th, after an evaluation visit to the
dialysis units in the disaster area. Dr R. Vanholder was able to report that the major
problem was over and that many of the chronic dialysis patients had returned to their
original units. However, much of the dialysis equipment for chronic dialysis had been used
for dialyzing the acute patients, and needed to be replaced with outside help. There was
an urgent need for 5,000 membranes.

On August 31st, 363 patients with acute renal failure were on dialysis,
29 patients had recovered and 48 patients had died. It is estimated that between 20 to 25%
of these patients underwent a fasciotomy for compartimental syndrome. On September 20th,
Prof. Sever reported the following numbers: 62 patients on dialysis, 126 patients
recovered and 83 patients died.

Although the full evaluation of this action is not yet complete the
initial results are an enormous tribute to the European ISN Task Force. Some lessons are
already clear. First, the long and sometimes frustrating preparation and planning enabled
prompt action to be taken, and probably saved many lives. Second, fast intervention would
not have been possible without the help of our partners such as MSF, the dialysis
industry, members of the Task Force in many European countries and the European and
Flemish Renal Nurses Associations.

Finally, the unbelievable courage, dedication and effort of the whole
Turkish medical and nephrological community made it possible for our teams to work in an
atmosphere of understanding and mutual trust, and has led to a friendship which will last
for many years to come. The “ISN flag” was instrumental in the establishment of
this good relationship.

Later we will communicate a more detailed scientific report of this
action.

Other Actions

The Task Force was further contacted for advice on the occasion of
other earthquakes in:

Athens, Greece on
September 7th 1999

Adapazari, Turkey on
September 13th 1999

Nantou, Taiwan on
September 22nd 1999

Oaxaca, Mexico on
September 30th 1999

According to their respective contact persons, no international support
for dialysis was necessary in these cases.

Finally, our sincere thanks for the help given by all our partners, by
industry, and not the least by two of the secretaries of the Renal Division of the
University Hospital Gent, Chantal Bergen and Ingrid Verslycken, who have worked many extra
hours in support of the activities.
 isn


Norbert Lameire is a member of the European Renal Disaster Relief Task Force and is
Chairman of the ISN Commission on ARF.

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The ISN Fellowship Program

Rashad S. Barsoum, MD, FRCP, FRCPE

The Fellowship program has been running since 1985 and is now one of
the most extensive ISN activities. Its purpose is to offer training opportunities for
young nephrologists in the developing world, and ultimately to improve the standards of
their “home institutions” upon their return. It also provides partial support
for the travel of selected young nephrologists to participate in international meetings.
The program also includes the “Visiting Scholarships” which support visits by
senior nephrologists from developed centers to developing units and enables them to spend
several weeks or months teaching and training the local staff.

The program has an annual budget of close to US$800,000, which covers
30 Fellowship years, 65 travel grants and 2 Senior Scholarships. About two thirds of the
fund is provided by ISN and the remaining one third by sister societies, the bi-annual ICN
budget, and from industry. A campaign has been recently set to increase the contribution
of industry. Many members of the Executive are involved with this task, which is expected
to significantly improve the chances of applicants’ acceptance far beyond the present
30%.

At least 50% of the training fellowship budget is restricted to
full-year Fellowships. The other half is used to support short-term training or
“brief visits” which facilitate technical training for nurses and technicians as
well as for doctors.

The Fellowship Program is orchestrated by the Secretary-General, who
chairs an international selection committee of 7 senior nephrologists . The opinion of
leading local nephrologists is often requested for the evaluation of applicants in their
regions.

The selection procedure has been recently revised, and now includes
three phases, data verification, evaluation, and selection.
Ultimately, selection is largely based on the quality of the candidate, and the training
program proposed by the host institution, which should match the home institution’s
needs. Geographical balance and the urgent need of particular regions are also taken into
consideration.

The title “ISN Fellow” is awarded to trainees who
successfully complete at least one-year training. Those trained for shorter periods are
entitled “ISN Scholars”. ISN Fellows are eligible for certain advantages
including free subscription to Kidney International for 1—2 years, priority in
selection for Congress travel grants, privileged renal sister links, library enhancement
program and others.

Full details about eligibility for this Program and the application
procedure are published in the ISN website as well as in Kidney International.
Deadlines for application are the end of January and end of July. Selection is made by mid
May and mid November each year.
 isn


Rashad Barsoum is Secretary-General of the ISN.

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XV
International Congress of Nephrology and XI Latin American Congress of Nephrology

Elvira Arrizurieta, MD

From May 2 through 6, 1999, the XV International Congress of Nephrology
and the XI Latin American Congress of Nephrology of the International Society (ISN) and
Latin American Society of Nephrology and Hypertension (SLANH), were held in Buenos Aires,
Argentina, with the Argentine Society of Nephrology (SAN) as host. This was the first time
that the ISN had held its traditional biannual congress in South America, and only the
second time in which it was held jointly with a regional society; in this case, with
SLANH.

The scientific program included two Plenary Lectures, named after
Donald Seldin and Claude Amiel. These were delivered by T. Kishimoto and R. Lifton on
Cytokines and Chemokines and on Genetic Hypertension, respectively. Five central
topics–Renal Injury and Repair, Diabetes, Hormones and the Kidney, Dialysis and Renal
Transplantation–were dealt with both from the basic and clinical aspects during the 4
days of the Congress. There were 21 Symposia on these topics, including three organized by
ISN Commissions and two by SLANH that were given in Spanish or Portuguese. There were 13
Continuous Medical Education courses, and a Nephrology Forum hosted by Kidney
International
. A total of 1839 free communications were presented as oral
communications or posters during the Congress. These came from Europe (41.6%), Asia and
Australia (29.6%), America (26.8%) and Africa (1.4%). The A.N. Richards award was
presented to Isidore Edelman and Hans Ussing, and the Jean Hamburger award to Robert
Heptinstall and Barry Brenner in plenary sessions. The SLANH granted the Victor Ra�l
Miatello Prize to Bernardo Rodriguez Iturbe and Manuel Mart�nez Maldonado in a special
session. Industry also participated in the scientific activity of the Congress through
four Symposia and sessions devoted to therapeutic updates.

The creation of the CW Gottschalk ISN Nephrology Archives was announced
during the ISN General Assembly.

A training course for 48 young Latin American nephrologists was carried
out before the Congress. This was the first time that a joint congress with the World
Council for Renal Care (WCRC) for nurses and kidney technicians (with 420 attendees) was
held within the framework of an ISN international congress. At the end of the meeting,
five satellite congresses were held, two in Brazil and the remaining three in Chile,
Uruguay and Argentina.

There were 5232 registrants at the Congress, 82% of whom were
nephrologists and the remainder consisted of their companions and industry and press
representatives, as well as nurses and technicians.

There was a highly successful social program. The Opening Ceremony was
held in Buenos Aires with speeches by the Local Organizing Committee president and by the
SLANH and ISN presidents — Pablo U. Massari and Kiyoshi Kurokawa. This was followed
by a reception cocktail which took place at the Col�n Theatre and included a tango and
folklore show. At the closing meeting, a dinner was served that included the typical
Argentine barbecue (asado) and dancing. There were also two small dinners, given by the
Presidents, which were marked by deep affection and good cheer.

The organization of the congress demanded a great effort from all those
involved in that task but the success achieved was ample compensation. It was a very
positive event for Latin-American nephrologists to enjoy first-hand contact with
international nephrology and an opportunity for the ISN to host a new and numerous group
desirous of progressing. Once again, Buenos Aires embraced us with its charm.
 isn


Elvira Arrizurieta was President of the Local Organizing Committee for the ISN
Congress.

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The
Commission on the History of Nephrology, the Archives of the ISN and the Video Legacy
Project

Kim Solez, MD

The ISN is becoming increasingly interested in the details of its
his-tory of its foundations. It is equally sensitive to the need of an international
organization to promote the study of the historical underpinnings of its discipline. The
Commission has taken on these issues as its raison d’�tre.

What we have

The Carl W. Gottschalk Archives

Through the offices of its previous Chairman, the late Carl W
Gottschalk, source material, including letters, photographs, manuscripts, documents etc.
which have been passed on by previous leaders of ISN have been collected into an archive.
This collection resides in the headquarters of the ISN in Amsterdam. The material has been
catalogued and is available through the ISN Website. Upon request, copies of the original
material can be made available to members.

Publications

The “Historical Archives” section of Kidney International
serves to promote creative work on the history of Nephrology. Peer-reviewed articles must
show evidence of a conceptual contribution or of a unique insight into historical issues
in order to be considered suitable for publication. Over the years an impressive array of
such articles have been published and have served to stimulate widening interesting in the
history of the discipline.

Scholarships

Without a stimulus to the interest and creativity of young
investigators and students, even history becomes hide-bound. The Commission awards History
Scholarships of $500 each to applicants who provide an outline of a proposed study and
evidence that they have a committed mentor to supervise the work. In this way, we hope to
stimulate new-found interests.

The Video Legacy Project

This is the largest and most impressive accomplishment of the
Commission, established and sustained by Professor J. Stewart Cameron and Professor Kim
Solez. Interviews with international leaders in the field of nephrology, who have reached
the age of professional retirement, have been captured on videotape. Two CD-ROMs now
display some of the highlights of the interviews. Recommendations for interviewees are
made by the History Commission to the ISN Executive, which selects the most appropriate
candidates. This program continues to expand. Edited material can be obtained from Janice
McDonald in the form of CD-ROMs, copies of the original video tapes, or transcripts. It is
also available for viewing in the archival space of the new cyberNephrology complex in
Edmonton as well as in the new archival space of the ISN Secretariat in Amsterdam which
opens in January 2000. Contact information for Janice McDonald is:

Janice McDonald,
Secretary/Assistant to Dr. Kim Solez
NKF cyberNephrology, 5B4.02
WCM HSC
University of Alberta
8440 112th Street
Edmonton, Alberta T6G 2R7
Canada
Email: [email protected]
Phone: 01780-407-8385
Fax: 01780-407-2608

What we need

We need to expand! We need contributions from the ISN membership to
expand the archives. These can be sent to the Chairman of the History Commission. They
will be catalogued and forwarded to the ISN headquarters. The name of the donor will be
included with all material received henceforth. We also need more contributions to the
Historical Archives section of Kidney International and these may well arise our of an
increased pool of recipients of History Scholarships.

We need expanded awareness of the Video Legacy resource. One avenue is
the biennial ISN Congress at which a videotaped interview and the interviewee appear
before an audience in an interactive session. It is hoped that these sessions will become
highlights of future congresses. We also plan to have a booth in the exhibition area where
participants in the Congress can meet the interviewees one-on-one.

Finally, we need an expansion of involvement. Members need to
communicate their interests and needs and the Commission will respond positively.
 isn


Kim Solez is Chair of the ISN Committee on Nephrology Informatics.

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Will Being Wired
Signal the End of the
Papyrocentric Era?

Saulo Klahr, MD

The editors and publishers of Kid-ney International have watched
the evolution of the Internet since the late 1980s with the vision of eventual electronic
publication. One of the reasons for the change in publishers from Springer-Verlag to
Blackwell Science in 1990 was Blackwell’s participation in the development of some of
the first international scientific electronic databases, and their commitment to research
and development of this evermore sophisticated technology of information dissemination. In
less than a decade the Internet has become a nearly indispensable tool to rapidly glean
information worldwide. Could it signal the end of the Gutenberg “papyrocentric”
era?

Last October, ISN members were mailed their access codes to our online
journal. Efforts have been made todevelop a website that is both useful and attractive,
and I invite you to send me your comments on how we can improve it in the future.

We have taken a cautious approach to the development of KI
online for many reasons. Programmers who have been working on the concepts for an
electronically accessed journal for the last decade have seen those concepts become
obsolete as the computer technology and capabilities have exploded in all directions.
Since the ISN is a nonprofit organization and the start-up fees are deep into six figures,
it seemed fiscally wise to observe what other organizations and societies were doing in
the field, and to build on their successes while avoiding their failures. We have wrestled
with some specific risks such as copyright, security, and cost-containment, and it is
likely that they will remain topics of debate and policy. However, it is also exciting to
move from the linear paper copy to play with the geometrically spacial electronic version
of KI, where hyperlinks to databases and abstract services such as Medline are
embedded in every citation and a key word search is available at the touch of a button.

The success of the Journal of Biological Chemistry, the first
full-text journal online in 1995, and the “speed of writing” online e-print
archives at Los Alamos created by Paul Ginsparg have greatly impacted the availability of
scientific information. The concepts and technology are steadily evolving and it is easy
to find biomedical websites and journals on most subjects.

The plethora of instant information is fast becoming overwhelming,
however. Last summer, the debate about non-peer reviewed and reviewed articles being
posted on a single site, E-biosci (formerly E-biomed), a new “PubMed Central”
website provided by the National Institutes of Health, has sparked comments from
publishers, editors, clinicians, researchers and patients. First proposed by Harold Varmus
as “a system that would make results from the world’s life sciences research
community freely available on the Internet”

(www.nih.gov/welcome/director/pubmedcentral/htm; Science 285:810, 1999), the
concept has provoked a lot of thought about why scientists publish their material in a
peer-reviewed journal, as well as fear for the total demise of publishing as we know it.
The public has been invited to comment, and the arguments both pro and con have provided
fascinating insights from many points of view.

Accessing accurate biomedical information has a direct impact on
patient care, and the most obvious danger is that misleading or even false statements will
be widely disseminated as patients more actively search through material published on the
Internet in the hopes of curing their disease. For this reason alone, I do not foresee
demise in academic publishing. The scientific process of deliberate study of a problem,
careful peer review, additional experiments to improve or broaden the findings, and
eventual acceptance and publication are a time-honored assurance of quality control of
information to the community. As we have moved away from postal mailing to FAX and express
mailing in the round-robin of the peer-review process, and next to an electronic review
system, this process has accelerated somewhat, but what will actually make the difference
is the immediate availability of each month’s issue online. For those in countries
where the delay in receiving the journal can be up to three months, this will be very
welcome.

Most of our colleagues complain about the amount of information they
must digest to stay abreast of the latest findings in their area of expertise. When asked
where they do most of their reading, the reply is usually “in bed” or
“while traveling”. As I consider the many advantages of this electronic
technological age, I find it difficult to imagine curling up in the evening with my
personal computer. Call me papyrocentric, but I remain more comfortable with my monthly
paper copy of Kidney International in my lap.
 isn


Saulo Klahr is Editor of Kidney
International
.


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Reports from the Regions

Michael Field, MD, FRACP

Most of the contents of the first ISN Newsletter describe im-portant
initiatives undertaken by the ISN, but we also want to hear about initiatives by local and
regional Societies of Nephrology. In the first of these Reports from the Regions, Michael
Field describes some initiatives being taken by the Australian and New Zealand Society of
Nephrology.

Australian & New Zealand Society of Nephrology

ANZSN has launched a number of initiatives in recent times that are of
particular relevance to nephrology in the Asia-Pacific region. More details about these
initiatives can be accessed via the ANZSN web site (http://www.nephrology.edu.au).

Following the success of DOQI and other national guidelines, Australian
and New Zealand nephrologists, in conjunction with ANZSN and the Australian Kidney
Foundation (AKF), are developing comprehensive guidelines for the practice of chronic
renal disease, dialysis and transplantation in our region. The guidelines are called
CARI–Caring for Australians with Renal Impairment. The first round is in draft form
on the web (http://www.cari.kidney.org.au) and is currently available for public comment.

ANZSN has established an education program directed predominantly at
trainees and isolated nephrologists. The second annual Postgraduate Course in Nephrology
will be held in conjunction with the Annual Scientific Meeting of ANZSN in Melbourne in
March 2000. In addition, this education program is extending into the Asia-Pacific region.
Prior to the Asian Colloquium in Nephrology in Bali in November 2000, there will be a
2-day Advanced Course in Nephrology, hosted by ANZSN.

The journal “Nephrology” has been revitalized with a new
editorial team consisting of nephrologists from Australia, New Zealand, and the
Asia-Pacific region. The first edition of the new look journal will appear in early 2000.
See http://www.blackwell-science-asia.com/nep for details.

The ANZDATA registry of Australian and New Zealand dialysis and
transplantation patients continues its tradition of strength, thanks to 100% compliance
with comprehensive biannual data collection by all nephrologists. With the addition of
infrastructure to more fully evaluate all existing and new data, ANZDATA is set to enter a
new phase of utility and importance. See http://www.anzdata.org.au

With the support of ANZSN and AKF, a number of exciting multicenter
epidemiological and interventional trials are in progress or about to commence. These
trials will have important implications for the practice of nephrology in our region.
 isn


Michael Field is member of the Medical and Scientific Advisory Committee of the ANZSN.

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Coming Soon

Future issues of the Newsletter will have major articles on:

  • Developing nephrology worldwide – the work of COMGAN
  • Helpful siblings: The Sister Renal Unit Program
  • Nephrology in Space: Cyber Nephrology and the Commission on Informatics
  • Out in Front: Nephrology Forefronts

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