History, Current Advances, Problems, and Pitfalls of Nephrology in Russia.

Background: The anatomy and physiology of kidneys as well as kidney diseases have been studied in Russia since the 18th century. However, there was a surge in interest in the 1920s, with numerous researchers and clinicians making substantial advances in the understanding of the pathophysiology, pathology, and diagnostics of kidney diseases. The field of nephrology as clinical practice can be traced back to 1957-1958, when the first beds for patients with kidney diseases became available and the first hemodialysis procedure was performed. Nephrology and hemodialysis units were opened soon after, offering kidney biopsy, corticosteroid and immunosuppressive therapies, and dialysis for acute renal failure and end stage of renal disease. In 1965 kidney transplantation commenced. Between 1970 and 1990, the number of centers providing care for patients with kidney diseases increased; however, they were insufficient to meet the demands of native kidney disorders and renal replacement therapy. To address this, several educational institutions established postgraduate programs in nephrology and dialysis, and professional societies and journals were funded. While economic changes at the end of the 1990s resulted in a rapid increase of dialysis service, kidney transplantation and pathology-based diagnostics of kidney diseases remained underdeveloped. During the last 2 decades cooperation among international professional societies, continuing medical education courses, and the translation and implementation of international guidelines have resulted in substantial improvements in the quality of care provided to patients with kidney diseases.

Summary: We describe the history and development of clinical nephrology, dialysis, kidney transplantation, education in nephrology and dialysis, professional societies and journals, and registry of patients on renal replacement therapy in Russia during almost 60 years. We also present the most recent registry data analysis, address current problems and difficulties, and stress the role of incorporation into the international nephrology community.

Key Message: Nephrology in Russia, despite currently experiencing many difficulties, made great advances during the 60 years of its development. General nephrology, nephropathology, and renal replacement therapy are developing fast; implementation of international guidelines, access to modern educational tools, and cooperation with international professional societies are improving the quality of care of renal patients and ensuring further progress.