Nephrology as a full-blown specialty was born in the middle of th 20th century with the advent of kidney replacement therapy. As regards knowledge of kidney diseases, decisive steps forward were introduction of percutaneous kidney biopsy (with examination by immunofluorescence staining and electron microscopy), as well as investigation of individual nephron function by micropuncture and more recently molecular biology techniques. As regards therapy, nephrology benefited the tremendous development of phamacology with the advent of diuretics, hypotensive agents and immunosuppressive drugs. But the revolution of the time was actually the invention of hemodialysis and peritoneal dialysis as well as the first success of kidney transplantation, allowing a rapidly growing number of patients worldwide to survive renal insufficiency for decades. Access to renal replacement therapy gave rise to novel ethical issues, which has been the foundation of medical bioethics.
Between the half of the 19th and the half of the 20th centuries, Richard Bright’s successors have a profound problem classifying diseases leading to uremia. The advent of immunology around the onset of the 20th century sheds new light on this issue, with the identification of immune-complex and antibody mediated disorders.
Martin Buysschaert : Could you discuss your journey as a student from the USA to Louvain and then your journey back to the USA to practice medicine? Michael Bergman: I was young at the time, about 22 years old before coming to Louvain after completing four years of College.
During the two centuries running from about 1650 to 1850, two scientific innovations account for key achievements in nephrology : new microscopes, which open the door to extending anatomical knowledge to physical processes, and the emergence of chemistry revealing the composition of stones as well as providing the measurement of albumin and urea levels.