action medical research grants

Action Medical Research

subtitle: Funding medical research, saving lives for 70 years

Paddington's favourite UK charity

breadcrumb navigation:

• current page Research

Apply for a research grant

Published on 9 August 2022

Updated: 19 January 2024

The aim of the charity is to prevent and treat disease and disability by funding vital medical research in hospitals or research institutions across the UK.

The remit focuses on child health to include problems affecting pregnancy, childbirth, babies, children and young people. 

Within child health, we support a broad spectrum of research with the objective of preventing and treating disease and disability.

Please note that our emphasis is on clinical research or research at the interface between clinical and basic science.  We pride ourselves that our research is both innovative and of a high standard as judged by rigorous peer review.

Within the above criteria, we also support research and development of equipment and techniques to improve diagnosis, therapy and assistive technology (including orthoses, prostheses and aids to daily living) and we encourage applications in the field of medical engineering.

If you have any questions about the schemes and the guidance provided please contact the Research Team at [email protected]

Apply for funding from Action

Apply for a project grant.

Applications should be of high quality as the scheme is very competitive and will be assessed by rigorous peer review. Please read the exclusions, as listed below, before you make your application.

Apply for a Research Training Fellowship

Applications are invited from medical graduates, clinicians, bioengineers, research nurses, physiotherapists and allied health professionals. Please read the exclusions, as listed below, before you make your application.

Before applying

Please note that we do not provide:

• grants towards service provision or audit studies
• grants purely for higher education courses, although Research Training Fellows are strongly encouraged to independently register for a PhD
• course fees for degrees or subsistence costs
• grants for medical or dental electives
• grants for work undertaken outside the UK
• any indirect costs such as administrative or other overheads imposed by the University or other Institution
• costs associated with advertising and recruitment of staff
• 'top up' funding for work supported by other funding bodies
• costs to attend conferences (current Action Medical Research grantholders may apply separately as the need arises during the grant)
• general appeals from other charities. Applications would normally come directly from research teams and projects need to be passed through our scientific peer review system
• grants for research into complementary / alternative medicine
• grants on how best to train clinical staff
• grants on social research, family relationships or socioeconomic research
• grants for very basic research with little likelihood of clinical impact within the short to medium term
• applicants based in core funded units can apply but need to demonstrate added value.

• U.S. Department of Health & Human Services

• Virtual Tour
• Staff Directory
• En Español

You are here

Grants & funding.

The National Institutes of Health is the largest public funder of biomedical research in the world. In fiscal year 2022, NIH invested most of its $45 billion appropriations in research seeking to enhance life, and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.

three-scientists-goggles-test-tube.jpg

Grants Home Page

NIH’s central resource for grants and funding information.

lab-glassware-with-colorful-liquid-square.jpg

Find Funding

NIH offers funding for many types of grants, contracts, and even programs that help repay loans for researchers.

calendar-page-square.jpg

Grant applications and associated documents (e.g., reference letters) are due by 5:00 PM local time of application organization on the specified due date.

submit-key-red-square.jpg

How to Apply

Instructions for submitting a grant application to NIH and other Public Health Service agencies.

female-researcher-in-lab-square.jpg

About Grants

An orientation to NIH funding, grant programs, how the grants process works, and how to apply.

binder-with-papers-on-office-desk-square.jpg

Policy & Compliance

By accepting a grant award, recipients agree to comply with the requirements in the NIH Grants Policy Statement unless the notice of award states otherwise.

blog-key-blue-square.jpg

Grants News/Blog

News, updates, and blog posts on NIH extramural grant policies, processes, events, and resources.

scientist-flipping-through-report-square.jpg

Explore opportunities at NIH for research and development contract funding.

smiling-female-researcher-square.jpg

Loan Repayment

The NIH Loan Repayment Programs repay up to $50,000 annually of a researcher’s qualified educational debt in return for a commitment to engage in NIH mission-relevant research.

Connect with Us

• More Social Media from NIH

Switch language:

Action Medical Research: celebrating decades of discovery

The UK BioIndustry Association has named Action Medical Research as its charity of the year for 2019. With a focus on funding breakthrough treatments for conditions affecting children, the charity has a history stretching back to the 1950s with the validation of the first UK polio vaccine.

• Share on Linkedin
• Share on Facebook

1952 – 1962: eradicating polio

The charity was founded in 1952 by Duncan Guthrie as he sought to find a cure for polio, which his daughter Janet was afflicted with. In the early 1950s, 8,000 people were paralysed by polio each year in the UK. The charity was originally called The National Fund for Poliomyelitis Research and changed its name to The National Fund for Research into Poliomyelitis and Other Crippling Diseases in 1960. Its funding helped to develop the first oral polio vaccine which successfully eradicated new cases of the disease in Britain.

Go deeper with GlobalData

Medical Marijuana - Innovative Pipeline Shows Promise for Treating ...

Global hematological cancer (blood cancer) therapy market to 2027 -..., premium insights.

The gold standard of business intelligence.

Find out more

Related Company Profiles

University college london, imperial college london, action medical research, queen's university.

A large share of the Action Medical Research polio funds went to Professor George Dick and his team at Queen’s University in Belfast. The team of researchers tested and develop two polio vaccines for use in the UK. The injectable Salk vaccine was first introduced in 1955 and the oral sugar cube Sabin vaccine was introduced in 1962.

1967 – 1981: ultrasound and the Matrix chair    

In 1967, the charity changed its name to The National Fund for Research into Crippling Diseases.

During the 1970s and 1980s the charity supported a number of projects working to develop safe ultrasound techniques for monitoring babies during pregnancy. In 1978, the charity funded Professor Ian Donald’s work to develop a pregnancy ultrasound technique by awarding him and his colleagues at the Western General Hospital, Edinburgh a grant for a real-time scanner to assess babies. In 1981, the charity provided further funding for a videotape recorder system enabling the doctors to study a baby’s movement in 2D for the first time.

How well do you really know your competitors?

Access the most comprehensive Company Profiles on the market, powered by GlobalData. Save hours of research. Gain competitive edge.

Your download email will arrive shortly

Not ready to buy yet? Download a free sample

We are confident about the unique quality of our Company Profiles. However, we want you to make the most beneficial decision for your business, so we offer a free sample that you can download by submitting the below form

Also in the 1980s, Action Medical Research supported researchers at University College London as they developed the award-winning Matrix seat to help severely disabled children with their posture. The seat can be closely fitted to a child’s body shape and avert pressure sores.  

1992: protecting children from meningitis

Thanks to the introduction of the Action Medical Research funded Hib vaccine in 1992, meningitis in children under five years old fell by 98% in the UK.

2003: official title  

The charity was renamed Action Medical Research in 2003.

2009: mapping brains

In 2009, Action Medical Research awarded over £148,000 to researchers based at Imperial College London so they could map brain development in healthy new-borns. In 2010, with support and additional funding from the charity, the same team received a grant of over £1m from the Engineering and Physical Sciences Research Council to build upon their brain map research and develop a computer programme to automatically identify areas of abnormal brain development on MRI scans, which could aid in the prevention of future disabilities for a child.

2018: new grants awarded for future research

In September 2018, Action Medical Research announced seven new grants with a total value of just over £1.2m. The grants have been awarded to universities and hospitals in the UK which are researching how to help sick babies and children.

The new studies started in late 2018 or early 2019 and include a study using brain scans to help identify babies at higher risk of developing autism or ADHD as well as research to help children with juvenile arthritis.

2019: Charity of the Year

Action Medical Research is the BioIndustry Association (BIA) Charity of the Year for 2019. The BIA will work with the charity to fund its ongoing research intends, and to promote links with biotech companies carrying out research and development.

Sign up for our daily news round-up!

Give your business an edge with our leading industry insights.

More Relevant

Forma therapeutics gets grant for usp30 inhibitor compounds for medical use, teladoc health gets grant for automated generation of structured medical notes during remote consultations, indivior gets grant for medication component mixing system with female and male syringes.

Gen AI and its use in medical devices and SaMD

Sign up to the newsletter: in brief, your corporate email address, i would also like to subscribe to:.

Pharma Technology Focus : Pharmaceutical Technology Focus (monthly)

Thematic Take (monthly)

I consent to Verdict Media Limited collecting my details provided via this form in accordance with Privacy Policy

Thank you for subscribing

View all newsletters from across the GlobalData Media network.

Action Medical Research

• Reference work entry
• First Online: 01 January 2020
• Cite this reference work entry

136 Accesses

You have full access to this open access chapter,  Download reference work entry PDF

Vincent House, North Parade, West Sussex, Horsham, RH12 2DP, United Kingdom.

(44) 14 0321 0406

[email protected]

www.action.org.uk

Action Medical Research is dedicated to preventing and treating disease and disability by funding vital medical research in United Kingdom-based hospitals and universities. The remit focuses on child health with an emphasis on clinical research or research at the clinical/basic interface. Research applications are judged by rigorous peer review.

Action Medical Research Project Grants

Subjects : A broad spectrum of research with the objective of preventing and treating disease and disability and alleviating physical disability. The remit focuses on child health to include problems affecting pregnancy, childbirth, babies, children and adolescents.

Purpose : To support one precisely formulated line of research

Eligibility : Open to researchers based in the United Kingdom. Grants are not awarded to other charities or for higher education

Level of Study : Unrestricted

Type : Project grant

Value : Varies

Length of Study : Up to 3 years, assessed annually

Frequency : Dependent on funds available

Study Establishment : Hospitals, universities and recognised research establishments in the United Kingdom

Country of Study : United Kingdom

Application Procedure : Applicants must submit a one-page outline of the project before an application form can be issued. Full details and outline proposals are available on the website

No. of awards offered : Varies

Closing Date : 20 November

Funding : Private, Trusts, Individuals

Contributor : Voluntary income

No. of awards given last year : 12

No. of applicants last year : 83 applications

Action Medical Research Training Fellowship

Purpose : To support training in research techniques and methodology applied to subjects relevant to the aims of the charity.

Eligibility : Open to researchers based in the United Kingdom. Grants are not awarded to other charities or for higher education.

Level of Study : Medical graduates, clinicians, bioengineers, research nurses, physiotherapists and allied health professionals

Type : Research Training Fellowship

Value : Up to £250,000

Length of Study : 2 or 3 years, assessed annually

Study Establishment : Hospitals, universities and recognised research establishments in the UK

Application Procedure : Applicants must submit an outline of the project and may then be invited to submit a full application. Full details are available on the website.

No. of awards offered : Typically 2 or 3 annually

No. of awards given last year : 2 awarded

No. of applicants last year : 26 applications

Additional Information : 13 full applications invited, 10 submitted, 5 interviewed

Editor information

Copyright information.

© 2020 Springer Nature Limited

About this entry

Cite this entry.

(2020). Action Medical Research. In: The Grants Register 2021. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95988-4_14

Download citation

DOI : https://doi.org/10.1057/978-1-349-95988-4_14

Published : 03 September 2020

Publisher Name : Palgrave Macmillan, London

Print ISBN : 978-1-349-95987-7

Online ISBN : 978-1-349-95988-4

eBook Packages : Education Reference Module Humanities and Social Sciences Reference Module Education

Share this entry

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

Federal Funding for Key Medical Programs in FY 2024: A Closer Look

• Congress recently finalized an appropriations package of nearly $2 trillion for fiscal year 2024, funding critical medical research and public health programs through September 30, 2024. 
• Many programs received flat funding, which failed to keep pace with inflation. 
• STS will continue to advocate for robust funding levels that exceed the rate of inflation for fiscal year 2025. 

In March, Congress passed its annual appropriations package for fiscal year (FY) 2024, allocating nearly $2 trillion to fund the government through September 30, 2024. This package includes resources for essential government agencies and research programs that drive medical advances, enhance care quality, and disseminate best practices. Below is a breakdown of the key programs that the STS supported and their funding outcomes. 

National Institutes of Health (NIH)

NIH is the primary agency responsible for biomedical and public health research in the United States. This work is crucial for understanding, treating, and preventing diseases. Strong funding for NIH helps ensure appropriate funding levels for key institutes that directly impact cardiothoracic conditions. 

Funding for FY24: $47.08 billion (a $300 million increase)

National Cancer Institute (NCI)

NCI leads the national effort to eliminate suffering and death caused by cancer. The agency supports research, training, and dissemination of information on cancer prevention, diagnosis, and treatment. 

Funding for FY24: $7.22 billion (a $120 million increase)

National Heart, Lung, and Blood Institute (NHLBI)

NHLBI provides global leadership in research, training, and education to prevent and treat heart, lung, blood, and sleep disorders. STS participates in coalitions to promote NHLBI funding and meets annually with its leadership to better understand current activities and funding needs. 

Funding for FY24: $3.98 billion (no change) 

Agency for Healthcare Research and Quality (AHRQ)

AHRQ aims to produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable. STS actively opposes efforts in Congress to terminate AHRQ funding. 

Funding for FY24: $370.5 million (a $3 million decrease)

Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH)

OSH leads national efforts to reduce tobacco-related death and disease. 

Funding for FY24: $125.85 million (no change)

Lung Cancer Program at Congressionally Directed Medical Research Programs (CDMRP)

Administered by the Department of Defense, the CDMRP finances high-impact, high-risk, and high-gain projects that accelerate medical research in specific areas. One of these programs, the Lung Cancer Research Program, has received $194.5 million in funding over the past ten years (FY09-FY22), making it the largest lung cancer research program outside of the NCI. This program specifically researches topics that include biomarkers of disease recurrence, cutting edge immunotherapies, targeted tests, and treatments with added emphasis on under-researched small cell lung cancer.  

Funding for FY24: $25 million for lung cancer research (no change) 

Research into Firearm Morbidity and Mortality Prevention

Administered by the CDC, NIH, and National Institute of Justice (NIJ), this research is critical for understanding and preventing firearm-related injuries and deaths. 

Funding for FY24: $12.5 million (no change)

Pediatric Specialty Loan Repayment Program

This program provides up to $100,000 in loan forgiveness to pediatric medical specialists to encourage them to pursue careers in underserved areas. Last year was the first time this program was funded after STS advocated for its creation for more than 10 years. Learn more . 

Funding for FY24: $10 million (no change)

Looking Forward

As Congress begins to determine appropriations levels for FY25, STS will continue to advocate for robust funding that exceeds inflation for these critical government programs, which are vital for advancing patient care and medical research.  

• RCPCH Learning
• Child Protection Portal
• Archives of Disease in Childhood
• BMJ Paediatrics Open
• RCPCH Committees

• Our strategy
• How we are funded
• Governance and structure
• Reports and statements
• Neurodegeneration
• Respiratory health
• Global health
• Rare Disease
• Support for MRC researchers
• Helping charities
• Our partners
• Available technologies
• Advise & Connect: Covid-19
• LifeArc Ventures
• Rare disease translational challenges
• Current funding opportunities
• Drug discovery
• Antibody humanisation
• IP management and technology transfer
• Diagnostics development
• Working at LifeArc
• Our culture
• Benefits and rewards
• Students and fellows
• How to apply
• Job vacancies
• Latest news
• Case studies
• Reports and publications

Action Medical Research and LifeArc announce another round of funding to support translational research into children’s rare diseases

Children’s charity Action Medical Research and independent medical research charity LifeArc are pleased to announce a fourth joint funding round aimed at supporting UK-based translational research projects that could lead to new interventions (therapeutics, diagnostics and devices) for infants, children or young people with a rare disease.

The charities have created a £1m fund for researchers seeking additional funding to progress promising translational research projects aimed at addressing a clear unmet medical need for children and young people with a rare disease.

The joint call is open to projects developing a broad range of intervention types (therapeutics, diagnostics, and devices), including the development of targeted gene therapy approaches that could be particularly well-placed to benefit the high proportion of monogenic paediatric rare diseases. Further information on remit, eligibility and how to apply can be found on the Action Medical Research website .

This is the fourth joint funding call issued by the charities. Projects successfully funded in the last round are expected to be announced this summer. In the 2020 funding round three projects were jointly funded; one optimising new drug treatments for Duchenne muscular dystrophy , another aiming to improve diagnosis and monitoring of hypertrophic cardiomyopathy in children , and a third project looking to develop new drug treatments for pyridoxine dependent epilepsy .

Two projects in the 2019 funding round were funded; one assessing whether the combination of existing drugs could be used as a new treatment for childhood leukaemia and another aiming to improve the effectiveness of a stem cell gene therapy for Hunter Syndrome.

A recent report for 2022 Rare Disease day focused on the impact an improved stem cell gene therapy could have for children with Hunter syndrome , highlighting how research funded by this joint scheme could have real benefit for patients.

Dr Catriona Crombie, Head of LifeArc’s Philanthropic Fund said: “Through this joint funding call, LifeArc and Action Medical Research have already committed over £1.1m to support five translational research projects focused on developing improved therapies and diagnostics for children and young people with rare disease.

“Our continued partnership with Action Medical Research will provide the funds and expertise to help translate further high-quality research into interventions that could benefit paediatric patients with rare disease.”

Dr Tracy Swinfield, Research Director at Action Medical Research said: “Our ongoing partnership with LifeArc enables us to fund cutting-edge medical research that could have a significant impact on the treatment of babies, children and young people living with rare and sometimes devastating disease. ”

The deadline for submitting an outline application is 21 June 2022. Please click here for more information on the joint fund.

– Ends –

Notes to editors

Outline applications can be made via the Action Medical Research website and will need to meet the guidelines provided. Projects of up to three years’ duration and costing a maximum of £250,000 will be considered. Researchers invited to submit a full application are expected to be informed of a final funding decision in summer 2023.

Follow Action Medical Research

Twitter: @actionmedres  and  @amr_events  Facebook: facebook.com/actionmedres Instagram: @actionmedres  and @actionevents

Action Medical Research is a leading UK-wide charity saving and changing children’s lives through medical research. For 70 years we’ve helped pioneer ways to prevent disease and develop treatments benefiting millions of people. Our research has helped to beat polio in the UK, develop ultrasound in pregnancy, fight meningitis and prevent stillbirths. But we urgently need to develop more new treatments and cures for sick babies and children and we can’t do it without you.

Join our fight for little lives today.

Charity reg. nos 208701 and SC039284

Surinder Maan Communications Manager [email protected] +44 (0)20 7391 2754

Follow LifeArc on LinkedIn or Twitter

LifeArc is a self-funded medical research charity. Our mission is to advance translation of early science into health care treatments or diagnostics that can be taken through to full development and made available to patients. We have been doing this for more than 25 years and our work has resulted in a diagnostic for antibiotic resistance and four licensed medicines. Our success allows us to explore new approaches to stimulate and fund translation.

LifeArc is proud to be renewing joint funding with Action Medical Research, which is the latest in a series of strategic collaborations that leverage LifeArc’ s expertise in translational science – advancing strong discoveries from the lab to a point where rare disease patients can benefit. This includes a recent £8m commitment made by LifeArc to support the delivery of new gene therapy treatment through a unique partnership with the MRC.

Through this partnership, LifeArc is partly funding a network of cutting-edge facilities – also known as Gene Therapy Innovation Hubs – to enable the progress of novel, academic gene therapy research into early-stage clinical trials and bring a new generation of medicines to healthcare. It is hoped that promising gene therapy approaches, such as those supported by LifeArc’s joint fund with Action Medical Research, may benefit from interaction with the Gene Therapy Innovation Hubs as they progress towards clinical trials.

LifeArc supports 8 new fellows through Crick Africa Network (CAN) partnership

The Crick Africa Network (CAN), a partnership between LifeArc, the Francis Crick Institute and 5 African institutions,…

LifeArc signs statement calling for the UK to lead the G7 on R&D investment

The Campaign for Science and Engineering (CaSE) has released a joint statement urging all political parties to…

LifeArc funds pivotal clinical trial to treat an ultra-rare genetic disease with possible link to leader of the mutiny on the Bounty in 1789

A pivotal clinical trial to look at repurposing the UK-licensed medicine, deferiprone, for patients with neuroferritinopathy, an…

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Kidney Dis (Basel)
• v.4(4); 2018 Nov

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

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.

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.

Historical Aspects

Russian scientists have been interested in the anatomy and physiology of kidneys as well as kidney diseases since the 18th century. Professor Shumlansky investigated renal anatomy and defended his thesis entitled “De structura renum: Tractatus physiologicoanatomicus” in 1776; the paper was republished in Strasburg in 1788 [ 1 ]. In 1853 Professor Polunin [ 2 ] described acute renal failure in patients with cholera, and Professor Zakharyin [ 3 ] published his paper entitled “Association between protein-containing urine and convulsions in pregnant women,” which was one of the first descriptions of eclampsia. Professor Bogolybov [ 4 ] defended his PhD thesis entitled “Renal pathology of parenchymal inflammation (Bright's disease)” in 1862, and in 1876 Professor Stolnykov [ 5 ] designed the quantitative method to detect protein levels in the urine. He also studied hemoglobinuria [ 6 ], and he published the association between renal ischemia and left ventricular hypertrophy in 1880 [ 7 ]. In 1882, Professor Ivanovsky [ 8 ] published his paper entitled “Bacterial inflammation of kidneys as a consequence of erysipelas.”

The first widely recognized historical case of kidney disease in Russia was the illness of Czar Alexander III, who suffered from severe edema, ascites, itching, dyspnea, and hemoptysis. His urinalysis showed the presence of proteins and casts, and he was diagnosed with “chronic interstitial inflammation of kidneys” and died from pulmonary edema on October 20, 1894. Among the attending doctors of Czar Alexander III during his last fatal illness were Professor Ernst Viktor von Leyden from Germany and Professor Grigory Zakharyin [ 9 ].

The most important achievement in the field of kidney diseases in 19th century Russia was the first model of nephrotoxic nephritis, developed by Professor Lindemann while working in Professor Mechnikov's laboratory. Lindemann [ 10 ] published his research entitled “Sur le mode d'action de certains poisons renaux” in the Annals of Institute Pasteur in 1900, in which he demonstrated the nephrotoxicity of heterologous anti-kidney sera in experimental animals. This model remains the most widely used animal model of crescentic glomerulonephritis.

The next phase of research commenced in the 1920s. In 1921, Professor Zymnitsky [ 11 ] implemented a simple kidney function test, based on the relative density of urine, which was known as the modified Volhard test. In 1929, Professor Tareev [ 12 ] published his book entitled “Anemia in Bright's disease.” He later published several monographs, summarizing his clinical experience, and highlighting the most important issues of pathophysiology, pathology, and clinical presentation of kidney diseases: “Kidneys and the Body” (1932), “Hypoproteinemic syndrome” (1933), “Kidney diseases” (1936), “Nephritis” (1958), “Fundamentals of Nephrology” (1972) [ 13 , 14 , 15 , 16 , 17 ], and many others, all of which became handbooks for several generations of nephrologists. In 1950, Professor Lang [ 18 ] published the monograph “Hypertensive disease,” in which he stressed the role of essential hypertension in kidney damage. In 1963, Professor Gynetsynsky [ 19 ] published “Physiological mechanisms of water-electrolyte balance,” where he described the details of water reabsorption in the distal nephron.

Development of Nephrology in Russia

General nephrology.

Nephrology as a field of medical practice started its development in Russia (which was then the Soviet Union) in 1957. An initiative of Professor Woffsy, one of the most recognized internists, introduced the first beds for patients with kidney diseases in the internal diseases unit of Moscow City Hospital No. 52 [ 20 ]. Professor Ratner, who as a resident studied internal medicine with Professor Lang in the then Leningrad (now known as Saint Petersburg), was invited to manage the patients and played a leading role during the fledging years of nephrology in Russia. Under her direction the nephrology beds transformed into the first nephrology unit in 1964, and in the same year, the first kidney biopsy in the Soviet Union was performed in the unit. Professor Ratner was also the first to successfully use corticosteroids to treat glomerulonephritis at the end of 1950s. The patient was a child with severe nephrotic syndrome. Immunosuppressants were first used by the initiative of Professor Tareev in 1959, and in 1961, Professors Woffsy and Ratner [ 21 ] published a paper entitled “Corticosteroid therapy of glomerulonephritis” in the Annals of Academy of Medical Science.

The first pediatric nephrology unit at the National Medical Research Center of Children's Health (the Research Institute of Pediatrics) was opened in 1965 by the initiative of Professor Studenikin, again headed by Professor Ratner. In 1970, Professor Veltischev started the division of inherited and acquired kidney diseases in the Research Clinical Institute of Pediatrics (which was then the Research Institute of Pediatrics and Children's Surgery), headed by Professor Ignatova till 2006 [ 22 ].

The second nephrology unit opened in Moscow City Hospital No. 52 in 1971, followed soon after with nephrology units opened in Moscow City Hospital No. 24 and the Moscow City Hospital n.a. S.P. Botkin (first headed by Dr. Alexander Lokshin). Other hospitals in Moscow, Saint Petersburg, and most big cities used the Moscow City Hospital No. 52 experience as a model when opening their respective units.

Professor Ratner was active as the leader of the rapidly growing renal service in Moscow until the end of 1980s. Her main interests were glomerulonephritis, transplanted kidney issues, and tubulointerstitial disorders, on which along with Professors Serov and Tomilina, she published a book entitled “Renal dysfunctions” in 1977 [ 23 ]. She also established a school of clinical nephrology, which is currently headed by Professor Tomilina.

In 1993 Professor Tomilina initiated the merging of two nephrology units - one for patients with native kidney diseases and the other for recipients of transplanted kidney - with the dialysis and outpatient units to create the Moscow City Nephrology Center, based in Moscow City Hospital No. 52. In 1998, the first intensive care unit for patients with kidney diseases opened in this center. The Moscow City Nephrology Center provides high-quality care for patients with any type of native and transplanted kidney diseases, not only to Moscow citizens, but also to referred patients. Professor Tomilina [ 24 ] recently summarized her clinical experience and published a monograph entitled “Selected Chapters in Nephrology.” The nephrology unit of the Moscow City Hospital n.a. S.P. Botkin also became a tertiary referral center at the beginning of 2000. The main priority of both centers is kidney biopsy with high-quality pathology diagnostics for a wide range of renal diseases. The nephropathology unit, which performs kidney biopsy readings for a vast majority of the population in Moscow, the surrounding area, and referred patients from other regions, is actually part of the Moscow City Nephrology Center.

Leading the intense development of clinical and research nephrology in Leningrad were Professor Ryabov, Professor Stavskaya, Dr. Jdanova, and Professor Bagrov - the successor of Professor Gynetsynsky, representing the Novosibirsk physiology school. For almost 50 years Professor Bagrov worked in the field of renal physiology and pathophysiology in close association with clinical practice. His monograph entitled “Water-electrolyte balance in Heart Failure” was published in 1984 [ 25 ]. A complex nephrology service, including the first outpatient unit for patients with kidney diseases, was organized in Leningrad in 1977 by Professor Ryabov. In 2003, several outpatient nephrology units in Saint Petersburg were merged under Professor Komandenko, and in 2008, the Saint Petersburg City Nephrology Center was opened. Currently, there are many nephrology units in Moscow, Saint Petersburg, and other big cities actively treating patients with glomerulonephritis, systemic diseases, diabetes, amyloidosis, chronic kidney disease (CKD) complications, and even orphan diseases such as atypical hemolytic uremic syndrome, Fabry disease, and cystinosis.

Unfortunately, the exact disease spectrum for CKD is not known, because general statistics, based on the main diagnosis only, does not represent CKD epidemiology. However, the database of the nephrology unit of the Moscow City Hospital n.a. S.P. Botkin provides some information and gives an impression of the disease spectrum. Table ​ Table1 1 represents unpublished data analysis.

Spectrum of CKD causes

Nephrology unit of Moscow City Hospital n.a. S.P. Botkin, 1994–2017 ( n = 18,368 cases).

The care and management of CKD include (1) CKD diagnostics and stratification; (2) monitoring of proteinuria, eGFR, and blood pressure; (3) treatment of underlying kidney diseases and measures for prevention of CKD progression; and (4) diagnostics, evaluation, and treatment of anemia, metabolic bone disease, cardiovascular complications, etc. Nephroprotection strategies, erythropoiesis-stimulating agents, iron supplementation, and phosphate binders are widely used. Diagnostic approaches and treatment of glomerulonephritis, including use of corticosteroids, immunosuppressants (cyclophosphamide, calcineurin inhibitors, mycophenolates, rituximab), and plasmapheresis are in agreement with international and national guidelines.

Of note, the International KDIGO Clinical Practice Guidelines for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease - Mineral and Bone Disorder; for Anemia in Chronic Kidney Disease; for Lipid Management in Chronic Kidney Disease; for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease; and for Glomerulonephritis were translated to Russian and widely implemented [ 26 , 27 , 28 , 29 , 30 ]. The translation of KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease - Mineral and Bone Disorder is currently in progress.

Hemodialysis (HD) techniques, invented and developed in western countries, immediately raised great interest in the Soviet Union. The first paper presenting an international experience of “artificial kidney” use was published by Dr. Parin [ 31 ] in 1955. The first Soviet “Artificial Kidney Apparatus” (AKA-60) was invented in 1957 by Yury Kozlov and his colleagues in the Research Institute of Experimental Surgical Technologies; production of the AKA-60 commenced in the Factory of Medical Equipment in Kazan [ 32 ].

In 1958, the first HD procedure using the Moeller dialysis machine was performed by Professors Pytel, Lopatkin, and Djavadzade at the University Clinic of Russian National Research Medical University n.a. N.I. Pyrogov (then the 2nd Moscow Medical Institute), based in Moscow City Hospital No. 1. Professor Pytel, a recognized urologist, was specifically interested in nephrology and had already studied crush syndrome and hepatorenal syndrome. In 1961, he published a monograph entitled “Artificial kidney and its clinical usage”, which was the first Russian monograph in the field [ 33 ].

Between 1958 and 1960 four “Experimental renal laboratories” for the treatment of patients with acute renal failure (ARF) opened: one in the Hematology Research Center (then the Research Institute of Blood Transfusion), one in Moscow Hospital No. 1, one in the Moscow City Hospital n.a. S.P. Botkin, and one in the 1st Moscow Medical University n.a. I.M. Sechenov (then the 1st Moscow Medical Institute). In 1960, the department of HD for patients with ARF, working in cooperation with the “Laboratory of Artificial Kidney” headed by Professor Gert Kulakov, was opened in the Moscow City Hospital n.a. S.P. Botkin. It was headed by Dr. Melikyan, who was one of the pioneers of HD in Russia and worked actively for 4 decades.

The year 1962 saw the first ever procedure not using donor blood with AKA-60 [ 34 ]. In 1964, the modified AKA-140 was invented, with production starting in Leningrad in 1969. HD was primarily used for the treatment of ARF in the setting of obstetric and surgical complications, poisoning, Hanta virus hemorrhagic fever, and crush syndrome. By 1971 more than 50 HD centers, equipped with AKA machines were successfully implemented throughout the Soviet Union. This allowed the expansion of indications for HD to chronic renal failure. The first dialysis unit for patients with end-stage renal disease (ESRD) was started in Moscow City Hospital No. 24 in 1967.

In 1963, the first pediatric patient, a 3-year-old child, was treated with HD. The first pediatric HD unit for the treatment of children with ARF was established in 1976 in the St. Vladimir Children's Hospital (then the Children's Hospital n.a. I.V. Rusakov), headed by Dr. Zverev. It was the only such unit in the country for many years, and later became the first center for children with hemolytic uremic syndrome; in 1991 peritoneal dialysis (PD) was successfully performed for the first time in Russia at this center.

Between 1971 and 1973 Hemodialysis System 6 (SHD-6) was invented by Professor Kulakov and engineer Balabanov. The new model of HD machine enabled HD procedures to be performed on 6 patients simultaneously [ 32 ]. The first two machines were introduced in 1974 in the “Laboratory of Artificial Kidney” in the Moscow City Hospital n.a. S.P. Botkin. Later, the SHD-8 replaced the SHD-6 and was introduced to clinical practice in many cities. In 1976, the first arteriovenous fistula was placed by Dr. Timokhov and Dr. Melikyan at the Moscow City Hospital n.a. S.P. Botkin, with arteriovenous fistula swiftly replacing shunts as the standard dialysis access technique in most HD units for ESRD patients soon after. The nephrology service in Leningrad first included HD units, working in cooperation with clinical nephrology and outpatient units; Professor Shostka coordinated this work.

During the next 2 decades, the number of HD units increased; however, they were insufficient to meet the demands of dialysis care for the ESRD patients. The biggest challenge for the dialysis service was the Spitak (Armenia) earthquake in 1988. At least 400 earthquake victims developed crush syndrome, and many of them with ARF were treated with HD. Most victims were evacuated from Armenia to Moscow and other major cities.

The economic changes following the collapse of the Soviet Union resulted in the substantial growth of dialysis care services. Unfortunately, this growth was not accompanied by the development of dialysis machine production, and now only imported equipment is used in the Russian Federation. While many intensive care units were equipped with dialysis machines that performed HD and continuous hemodiafiltration, the PD program for adult patients was started in 1995 to improve dialysis services; the first three units were opened in the Moscow City Clinical Hospital No. 52, Moscow City Hospital n.a. S.P. Botkin, and Moscow City Clinical Hospital No. 7, followed by Mariinskaya City Hospital, Saint Petersburg, and later in the other big cities. The PD unit of Moscow City Clinical Hospital No. 52 is actually the biggest in the Russian Federation.

In 2002, the Ministry of Health issued an order regarding “Excellence of Organization of Dialysis Care,” whereby public-private partnership implementation resulted in a rapid increase in the HD outpatient units. The International KDIGO and ERBP Guidelines concerning CKD and acute kidney injury were translated to Russian and widely implemented [ 30 , 35 , 36 ].

Evaluation of the disease spectrum of ESRD is based on the data from the Registry of patients on renal replacement therapy (RRT), started by the Russian Dialysis Society in 1998. The available individual data analysis is shown in Table ​ Table2 2 [ 37 ].

Causes of ESRD in patients on hemodialysis and peritoneal dialysis

Russian Dialysis Society Registry, 2011–2013 ( n = 15,880 patients).

The evaluation and management of patients receiving RRT include monitoring of dialysis dose and key quality indicators, blood pressure, body mass index, serum albumin, hemoglobin, total cholesterol, total calcium, serum phosphates, and parathyroid hormone. Comorbidities, treatment patterns, mortality, and survival are also evaluated on a regular basis. Patients on RRT receive antihypertensive medications, iron supplementation, erythropoiesis-stimulating agents, phosphate binders, and calcimimetics.

Transplantation

The first kidney transplantation from a deceased donor was performed by Dr. Voronoy in 1933 in Kherson (now a territory of Ukraine). While the procedure was not successful, the first ever attempt, published in 1936, enabled further developments [ 38 ]. The first successful kidney transplantation from a living donor, in this case a relative, was performed by Professor Petrovsky at the Russian Research Center of Surgery in 1965. In 1967, the National Medical Research Center of Transplantology and Artificial Organs n.a. V.I. Shumakov (then the Research Institute of Organ and Tissue Transplantation, first headed by Professor Solovyov) was created by Professor Petrovsky. Professor Petrovsky, along with Professor Solovyov and his group, published a book entitled “Kidney transplantation” in 1969 [ 39 ], when the program of kidney transplantation from deceased donors was initiated and widely implemented by Professor Shumakov, who headed the Research Institute of Organ and Tissue Transplantation for more than 30 years since 1974. The number of centers performing kidney transplantation exclusively from deceased donors increased over the next 2 decades. Professor Phyliptsev played a leading role in the implementation of kidney transplantation for almost 3 decades. In 1990, the first center for pediatric kidney transplantation was opened in the Russian Children's Clinical Hospital.

In 1992, the federal legislation regarding “transplantation of organs and/or tissues” was introduced, whereby only direct relatives are allowed to donate kidneys for transplantation. Several regulatory documents have been released since the order addressing “regalement of brain death diagnostics” (2014). The program of kidney transplantation from living donors commenced in 1999 in the National Medical Research Center of Transplantology and Artificial Organs, headed by Professor Moysuk, who summarized the experience of the first 2 years in the article “Kidney transplantation from living relative donor” [ 40 ].

The first Department of Nephrology came from the Department of Internal and Occupational Diseases of the 1st Moscow Medical University n.a. I.M Sechenov (formerly known as the Faculty of Medicine of Imperator's Moscow University, created in 1755), which started in 1930 and was headed by Professor Tareev from 1950. Under his leadership, nephrology became one of the main priorities, and in 1966 the Clinic of Nephrology, Internal and Occupational Diseases opened, merging the Department of Nephrology, the Department of Internal and Occupational Diseases, and the Nephrology and HD units. Between 1986 and 2017, the head of the Clinic of Nephrology was Professor Mukhin. In 1972, Professor Tareev initiated the Laboratory of Nephrology Problems, which was headed by his daughter, Professor Tareeva, from 1975 [ 41 ].

An educational course on hemodialysis at the Russian Medical Academy of Continuous Postgraduate Education (formerly the Central Institute of Medical Qualification, created in 1930) was initiated by Professor Kulakov in 1965, based at the “Laboratory of Artificial Kidney”. In 1982, this educational course developed into the first Department of Nephrology and Hemodialysis, headed by Professor Kulakov [ 32 ]. The Department was, and still is, based in the Moscow City Hospital n.a. S.P. Botkin; the close relationships between academia and clinical practice ensured the development of the field. Currently the Department is headed by Professor Ermolenko, one of the opinion leaders in the field, whose monograph entitled “Chronic Hemodialysis” was published in 1982 [ 42 ].

In 1996, the Research Institute of Nephrology was created at the 1st Saint Petersburg Medical University n.a. I.P. Pavlov (formerly the Women's Medical Institute, and later the 1st Leningrad Medical Institute), with Professor Ryabov as the first director. The Institute of Nephrology merged the Course of Nephrology and Dialysis (later the Department of Nephrology and Dialysis, headed by Professor Eacayan), the Department of Internal Medicine (formerly the Department of Internal Diseases, created in 1914 and headed by Professor Lang from 1919 to 1921), and several laboratories with the clinical nephrology unit.

A course of “efferent therapy” was started in 1994 at the Saint Petersburg Medical Academy of Postgraduate Education (formerly the Imperator's Clinical Institute, created in 1896). The course was later changed to the Department of Nephrology and Efferent Therapy and existed until 2011, when the Saint Petersburg Medical Academy of Postgraduate Education merged with the Saint Petersburg Medical Academy n.a. I.M. Mechnikov (formerly the Institute of Psychoneurology, created in 1907) under the name North-Western State Medical University n.a. I.M. Mechnikov.

In 2004, the Department of Nephrology, headed by Professor Tomilina, opened in the Moscow State University of Medicine and Dentistry (formerly the Moscow Institute of Medicine and Dentistry, created from the Moscow State Institute of Dentistry in 1949). This is a unique institution, providing postgraduate education in the fields of clinical nephrology, nephropathology, dialysis, and transplantation.

All of the abovementioned institutions provide professional education for residents and PhD students as well as certification courses and short-term continuing medical education (CME) courses.

The Society of Nephrology and Immunopathology, as part of the Moscow Scientific Society of Therapeutics created in 1895, started its work in 1958 and is currently active, conducts monthly meetings, and is devoted to selected issues of clinical nephrology, immunonephrology, and nephropathology.

The Scientific Society of Nephrology (SSN) was founded in 1969 by Professor Tareev, who was the President of the Society for almost 15 years. The congresses of the SSN have been conducted every 6 years since 1974, and during the intervening years Nephrology Summer Schools, initiated by Professor Natochin, the successor of Professor Gynetsynsky, were the most important events.

First contacts with ISN leadership were established by Professor Tomilina in 1994, when she invited Professor Brenner and Professor Dirks to attend the SSN meeting in Moscow. In 1995, the first CME course under the aegis of the ISN, ERA-EDTA, and IPNA was conducted in Moscow. The formal organizer was the SSN, but Professor Tomilina was the driving force. Among the invited international speakers were Professor Cameron and Professor Lameire. Unfortunately, due to formal official regulations the SSN was unable to continue its work for several years. The Scientific Society of Russian Nephrologists, the successor of the SSN, was started in 2005, conducting congresses and plenary assemblies and creating national guidelines and protocols.

In 1997, the Union of Pediatric Nephrologists was funded by an initiative of Professor Papayan [ 22 ]. In 1998, the Russian Dialysis Society (RDS) was established, with Professor Tomilina as the first president. This society is currently the most active professional society of nephrologists in Russia. It is affiliated with the ISN, ERA-EDTA, and EKHA, and cooperates with KDIGO, ERBP, and WKD leadership. The RDS is specifically dedicated to the education of nephrologists throughout the Russian Federation, and conducts up to five CME conferences each year in Moscow, Saint Petersburg, and the big cities in Siberia, Volga, Far East, North West, North, and South Regions. Numerous international leaders of nephrology deliver talks at these meetings as invited speakers, as well as conducting ISN Educational Ambassadors Courses. The RDS also supports the registry and the journal Nephrology and Dialysis (see below). Translations of most KDIGO and ERBP Guidelines and World Kidney Day Editorials were undertaken and published by RDS initiatives [ 26 , 27 , 28 , 29 , 30 , 35 , 36 , 43 , 44 ].

The first journal to publish papers with nephrology articles in Russian was Urology and Nephrology , which was started in 1968 on the basis of the Urology journal, issued since 1965. The journal Nephrology was started by Professor Smirnov in Saint Petersburg in 1997 and was the first journal to publish a wide range of articles in the field.

In 1998, the journal Nephrology and Dialysis (an official journal of the RDS) was initiated by Professor Tomilina. This journal is the most influential nephrology journal in Russia with one of the highest impact factors among all medical journals in Russia. The journal Clinical Nephrology was started in 2009, and was edited by Professor Mukhin till 2017.

In 1998, Professor Tomilina initiated the registry of patients on RRT. The registry data is published every other year in the journal Nephrology and Dialysis , providing detailed information about many aspects of RRT in Russia. These include information not only about the number of centers and patients, but also on issues of anemia, hypertension, CKD-MBD management, viral hepatitis diagnostics and treatment, and many other aspects. The registry is affiliated with the ERA-EDTA Registry, providing data for international publications.

The most recent analysis, which includes published data till the end of 2015 [ 45 ] and unpublished data up to the end of 2016, shows that the total number of centers providing RRT is 506 (including 466 providing HD, 111 for PD, and 37 for kidney transplantation), with many centers providing two or three modalities. Of note, only centers providing care to both adult and pediatric patients with ESRD were included, while centers providing care specifically to patients with acute kidney injury were not registered. The number of patients with ESRD on HD + PD by the end of 2016 was 44,771 (33,876 on HD, 8,537 on PD, and 2,358 living with transplanted kidney); the mean ratio was 305 per million inhabitants. Furthermore, the number of patients on HD in 2016 was 78% greater than that in 2010, mainly due to the development of public-private partnership.

Current Problems

• Absence of nephrology courses for students in Medical schools
• Relatively short-term professional postgraduate education (2-year residency, absence of fellowship programs)
• Lack of certified nephrologists
• Under-recognition of CKD burden by health authorities and policy makers
• Under-diagnostics of CKD in the adult population
• Lack of cooperation among nephrologists and general practitioners, endocrinologists, cardiologists, and other specialists
• Under-diagnostics of CKD and ESRD in the pediatric population
• Lack of nephrology units, disproportionate to the number of dialysis units, especially outside big industrial areas
• Lack of renal pathologists and unavailability of kidney biopsy in many regions
• Under-development of PD
• Uneven distribution of dialysis service throughout the territory of the country, with several remote regions still poorly covered by RRT
• Lack of transplantation and insufficient organ har vesting
• Insufficient funds for research

Conclusions

Nephrology in Russia, despite currently experiencing many difficulties, made great advances during the 60 years of its development. General nephrology, nephropathology, and RRT 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.

Statement of Ethics

No ethic approval is required for this type of study.

Disclosure Statement

The author declares no conflict of interest.

Funding and Partnerships

• Open Funding Opportunities Become A Grant Reviewer
• Disparity Impact Strategy

Open Funding Opportunities

Community level innovations for improving health outcomes.

The Office of Minority Health announces the anticipated availability of funds for Fiscal Year (FY) 2024 under the authority of 42 U.S.C. § 300u-6 (Section 1707 of the Public Health Service Act).

This notice solicits applications for projects to demonstrate that community level innovations that reduce barriers related to social determinants of health (SDOH) can increase use of preventive health services and make progress toward Leading Health Indicator (LHI) targets. LHIs are a subset of high priority Healthy People 2030 (HP2030) objectives selected to drive action toward improving health and well-being. SDOH are described in HP2030 as conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

We anticipate the availability of $8,000,000 for up to 14 awards, ranging from $475,000 to $600,000 annually, for a period of performance of up to 48 months. Recipients will be required to report on progress and milestones as part of an annual noncompeting continuation application. Costs of medical services are unallowable under this funding opportunity.

After 36 months, we anticipate offering a competing continuation opportunity for an additional 12-month budget period (i.e., a fifth budget period) to support selected successful projects in their transition to sustainability. Funding available for the additional budget period is not guaranteed nor expected to be at the same level of previous budget periods.

The Office of the Assistant Secretary for Health (OASH) Grants and Acquisitions Management Division (GAM) will administratively support this competition. GAM encourages all applicants to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this notice to ensure that applications comply with all requirements and instructions.

Register for the webinar here: https://www.zoomgov.com/webinar/register/WN__uL9Z5gFRA-Bcyyhi55LlQ

Announcement: https://www.grants.gov/search-results-detail/349434

For information on program requirements, please contact the program office representative: Paul Rodriguez at [email protected] .

Children’s charity seeks riders for North Wessex Downs cycle challenge

A charity cycling challenge in the North Wessex Downs is calling for riders to sign up now.

Cycling challenge, RIDE Wessex Downs, is taking place in this area, designated an Area of Outstanding Natural Beauty, in aid of children’s charity, Action Medical Research.

The event will commence on Sunday, April 14 with five routes to choose from — ranging from 34 to 100 miles.

Head of events at Action Medical Research (AMR), Felicity Louden, said: “We are excited to be back in the North Wessex Downs for our first sportive in the season.

“In only in its third year, RIDE Wessex Downs is going from strength to strength, and we hope that cyclists will join us for what promises to be another great day in the saddle and help drive forward vital medical research for babies and children at the same time.”

The routes, both on road and off-road, will set out from Pangbourne College and feature challenging hills and breathtaking views.

Cyclists participating in RIDE Wessex Downs will be raising money to help fund medical research into conditions affecting babies and children, including epilepsy, prematurity, meningitis, cerebral palsy, brain cancer and some rare conditions.

Entry costs between £36.50 and £48.50, which includes chip timing, food and water stations, marshals, mechanics and medals.

This event is part of the charity’s popular RIDE series of one-day bike rides, which take place in locations across the UK.

Visit www.action.org.uk/wessexdowns for more information and to register.

AMR is a UK-wide charity which has been funding medical breakthroughs into tackling diseases affecting children since 1952.

It helped to introduce the first polio vaccines in the UK, developing the use of ultrasound in pregnancy and testing the rubella vaccine.

Historical Aspects

Development of nephrology in russia, current problems, conclusions, acknowledgments, statement of ethics, disclosure statement, history, current advances, problems, and pitfalls of nephrology in russia.

• Split-Screen
• Article contents
• Figures & tables
• Supplementary Data
• Peer Review
• Open the PDF for in another window
• Get Permissions
• Cite Icon Cite
• Search Site

Elena Zakharova; History, Current Advances, Problems, and Pitfalls of Nephrology in Russia. Kidney Dis 15 November 2018; 4 (4): 238–245. https://doi.org/10.1159/000492634

Download citation file:

• Ris (Zotero)
• Reference Manager

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.

Russian scientists have been interested in the anatomy and physiology of kidneys as well as kidney diseases since the 18th century. Professor Shumlansky investigated renal anatomy and defended his thesis entitled “De structura renum: Tractatus physiologicoanatomicus” in 1776; the paper was republished in Strasburg in 1788 [ 1 ]. In 1853 Professor Polunin [ 2 ] described acute renal failure in patients with cholera, and Professor Zakharyin [ 3 ] published his paper entitled “Association between protein-containing urine and convulsions in pregnant women,” which was one of the first descriptions of eclampsia. Professor Bogolybov [ 4 ] defended his PhD thesis entitled “Renal pathology of parenchymal inflammation (Bright’s disease)” in 1862, and in 1876 Professor Stolnykov [ 5 ] designed the quantitative method to detect protein levels in the urine. He also studied hemoglobinuria [ 6 ], and he published the association between renal ischemia and left ventricular hypertrophy in 1880 [ 7 ]. In 1882, Professor Ivanovsky [ 8 ] published his paper entitled “Bacterial inflammation of kidneys as a consequence of erysipelas.”

The first widely recognized historical case of kidney disease in Russia was the illness of Czar Alexander III, who suffered from severe edema, ascites, itching, dyspnea, and hemoptysis. His urinalysis showed the presence of proteins and casts, and he was diagnosed with “chronic interstitial inflammation of kidneys” and died from pulmonary edema on October 20, 1894. Among the attending doctors of Czar Alexander III during his last fatal illness were Professor Ernst Viktor von Leyden from Germany and Professor Grigory Zakharyin [ 9 ].

The most important achievement in the field of kidney diseases in 19th century Russia was the first model of nephrotoxic nephritis, developed by Professor Lindemann while working in Professor Mechnikov’s laboratory. Lindemann [ 10 ] published his research entitled “Sur le mode d’action de certains poisons renaux” in the Annals of Institute Pasteur in 1900, in which he demonstrated the nephrotoxicity of heterologous anti-kidney sera in experimental animals. This model remains the most widely used animal model of crescentic glomerulonephritis.

The next phase of research commenced in the 1920s. In 1921, Professor Zymnitsky [ 11 ] implemented a simple kidney function test, based on the relative density of urine, which was known as the modified Volhard test. In 1929, Professor Tareev [ 12 ] published his book entitled “Anemia in Bright’s disease.” He later published several monographs, summarizing his clinical experience, and highlighting the most important issues of pathophysiology, pathology, and clinical presentation of kidney diseases: “Kidneys and the Body” (1932), “Hypoproteinemic syndrome” (1933), “Kidney diseases” (1936), “Nephritis” (1958), “Fundamentals of Nephrology” (1972) [ 13-17 ], and many others, all of which became handbooks for several generations of nephrologists. In 1950, Professor Lang [ 18 ] published the monograph “Hypertensive disease,” in which he stressed the role of essential hypertension in kidney damage. In 1963, Professor Gynetsynsky [ 19 ] published “Physiological mechanisms of water-electrolyte balance,” where he described the details of water reabsorption in the distal nephron.

General Nephrology

Nephrology as a field of medical practice started its development in Russia (which was then the Soviet Union) in 1957. An initiative of Professor Woffsy, one of the most recognized internists, introduced the first beds for patients with kidney diseases in the internal diseases unit of Moscow City Hospital No. 52 [ 20 ]. Professor Ratner, who as a resident studied internal medicine with Professor Lang in the then Leningrad (now known as Saint Petersburg), was invited to manage the patients and played a leading role during the fledging years of nephrology in Russia. Under her direction the nephrology beds transformed into the first nephrology unit in 1964, and in the same year, the first kidney biopsy in the Soviet Union was performed in the unit. Professor Ratner was also the first to successfully use corticosteroids to treat glomerulonephritis at the end of 1950s. The patient was a child with severe nephrotic syndrome. Immunosuppressants were first used by the initiative of Professor Tareev in 1959, and in 1961, Professors Woffsy and Ratner [ 21 ] published a paper entitled “Corticosteroid therapy of glomerulonephritis” in the Annals of Academy of Medical Science.

The first pediatric nephrology unit at the National Medical Research Center of Children’s Health (the Research Institute of Pediatrics) was opened in 1965 by the initiative of Professor Studenikin, again headed by Professor Ratner. In 1970, Professor Veltischev started the division of inherited and acquired kidney diseases in the Research Clinical Institute of Pediatrics (which was then the Research Institute of Pediatrics and Children’s Surgery), headed by Professor Ignatova till 2006 [ 22 ].

The second nephrology unit opened in Moscow City Hospital No. 52 in 1971, followed soon after with nephrology units opened in Moscow City Hospital No. 24 and the Moscow City Hospital n.a. S.P. Botkin (first headed by Dr. Alexander Lokshin). Other hospitals in Moscow, Saint Petersburg, and most big cities used the Moscow City Hospital No. 52 experience as a model when opening their respective units.

Professor Ratner was active as the leader of the rapidly growing renal service in Moscow until the end of 1980s. Her main interests were glomerulonephritis, transplanted kidney issues, and tubulointerstitial disorders, on which along with Professors Serov and Tomilina, she published a book entitled “Renal dysfunctions” in 1977 [ 23 ]. She also established a school of clinical nephrology, which is currently headed by Professor Tomilina.

In 1993 Professor Tomilina initiated the merging of two nephrology units – one for patients with native kidney diseases and the other for recipients of transplanted kidney – with the dialysis and outpatient units to create the Moscow City Nephrology Center, based in Moscow City Hospital No. 52. In 1998, the first intensive care unit for patients with kidney diseases opened in this center. The Moscow City Nephrology Center provides high-quality care for patients with any type of native and transplanted kidney diseases, not only to Moscow citizens, but also to referred patients. Professor Tomilina [ 24 ] recently summarized her clinical experience and published a monograph entitled “Selected Chapters in Nephrology.” The nephrology unit of the Moscow City Hospital n.a. S.P. Botkin also became a tertiary referral center at the beginning of 2000. The main priority of both centers is kidney biopsy with high-quality pathology diagnostics for a wide range of renal diseases. The nephropathology unit, which performs kidney biopsy readings for a vast majority of the population in Moscow, the surrounding area, and referred patients from other regions, is actually part of the Moscow City Nephrology Center.

Leading the intense development of clinical and research nephrology in Leningrad were Professor Ryabov, Professor Stavskaya, Dr. Jdanova, and Professor Bagrov – the successor of Professor Gynetsynsky, representing the Novosibirsk physiology school. For almost 50 years Professor Bagrov worked in the field of renal physiology and pathophysiology in close association with clinical practice. His monograph entitled “Water-electrolyte balance in Heart Failure” was published in 1984 [ 25 ]. A complex nephrology service, including the first outpatient unit for patients with kidney diseases, was organized in Leningrad in 1977 by Professor Ryabov. In 2003, several outpatient nephrology units in Saint Petersburg were merged under Professor Komandenko, and in 2008, the Saint Petersburg City Nephrology Center was opened. Currently, there are many nephrology units in Moscow, Saint Petersburg, and other big cities actively treating patients with glomerulonephritis, systemic diseases, diabetes, amyloidosis, chronic kidney disease (CKD) complications, and even orphan diseases such as atypical hemolytic uremic syndrome, Fabry disease, and cystinosis.

Unfortunately, the exact disease spectrum for CKD is not known, because general statistics, based on the main diagnosis only, does not represent CKD epidemiology. However, the database of the nephrology unit of the Moscow City Hospital n.a. S.P. Botkin provides some information and gives an impression of the disease spectrum. Table 1 represents unpublished data analysis.

Spectrum of CKD causes

The care and management of CKD include (1) CKD diagnostics and stratification; (2) monitoring of proteinuria, eGFR, and blood pressure; (3) treatment of underlying kidney diseases and measures for prevention of CKD progression; and (4) diagnostics, evaluation, and treatment of anemia, metabolic bone disease, cardiovascular complications, etc. Nephroprotection strategies, erythropoiesis-stimulating agents, iron supplementation, and phosphate binders are widely used. Diagnostic approaches and treatment of glomerulonephritis, including use of corticosteroids, immunosuppressants (cyclophosphamide, calcineurin inhibitors, mycophenolates, rituximab), and plasmapheresis are in agreement with international and national guidelines.

Of note, the International KDIGO Clinical Practice Guidelines for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease – Mineral and Bone Disorder; for Anemia in Chronic Kidney Disease; for Lipid Management in Chronic Kidney Disease; for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease; and for Glomerulonephritis were translated to Russian and widely implemented [ 26-30 ]. The translation of KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease – Mineral and Bone Disorder is currently in progress.

Hemodialysis (HD) techniques, invented and developed in western countries, immediately raised great interest in the Soviet Union. The first paper presenting an international experience of “artificial kidney” use was published by Dr. Parin [ 31 ] in 1955. The first Soviet “Artificial Kidney Apparatus” (AKA-60) was invented in 1957 by Yury Kozlov and his colleagues in the Research Institute of Experimental Surgical Technologies; production of the AKA-60 commenced in the Factory of Medical Equipment in Kazan [ 32 ].

In 1958, the first HD procedure using the Moeller dialysis machine was performed by Professors Pytel, Lopatkin, and Djavadzade at the University Clinic of Russian National Research Medical University n.a. N.I. Pyrogov (then the 2nd Moscow Medical Institute), based in Moscow City Hospital No. 1. Professor Pytel, a recognized urologist, was specifically interested in nephrology and had already studied crush syndrome and hepatorenal syndrome. In 1961, he published a monograph entitled “Artificial kidney and its clinical usage”, which was the first Russian monograph in the field [ 33 ].

Between 1958 and 1960 four “Experimental renal laboratories” for the treatment of patients with acute renal failure (ARF) opened: one in the Hematology Research Center (then the Research Institute of Blood Transfusion), one in Moscow Hospital No. 1, one in the Moscow City Hospital n.a. S.P. Botkin, and one in the 1st Moscow Medical University n.a. I.M. Sechenov (then the 1st Moscow Medical Institute). In 1960, the department of HD for patients with ARF, working in cooperation with the “Laboratory of Artificial Kidney” headed by Professor Gert Kulakov, was opened in the Moscow City Hospital n.a. S.P. Botkin. It was headed by Dr. Melikyan, who was one of the pioneers of HD in Russia and worked actively for 4 decades.

The year 1962 saw the first ever procedure not using donor blood with AKA-60 [ 34 ]. In 1964, the modified AKA-140 was invented, with production starting in Leningrad in 1969. HD was primarily used for the treatment of ARF in the setting of obstetric and surgical complications, poisoning, Hanta virus hemorrhagic fever, and crush syndrome. By 1971 more than 50 HD centers, equipped with AKA machines were successfully implemented throughout the Soviet Union. This allowed the expansion of indications for HD to chronic renal failure. The first dialysis unit for patients with end-stage renal disease (ESRD) was started in Moscow City Hospital No. 24 in 1967.

In 1963, the first pediatric patient, a 3-year-old child, was treated with HD. The first pediatric HD unit for the treatment of children with ARF was established in 1976 in the St. Vladimir Children’s Hospital (then the Children’s Hospital n.a. I.V. Rusakov), headed by Dr. Zverev. It was the only such unit in the country for many years, and later became the first center for children with hemolytic uremic syndrome; in 1991 peritoneal dialysis (PD) was successfully performed for the first time in Russia at this center.

Between 1971 and 1973 Hemodialysis System 6 (SHD-6) was invented by Professor Kulakov and engineer Balabanov. The new model of HD machine enabled HD procedures to be performed on 6 patients simultaneously [ 32 ]. The first two machines were introduced in 1974 in the “Laboratory of Artificial Kidney” in the Moscow City Hospital n.a. S.P. Botkin. Later, the SHD-8 replaced the SHD-6 and was introduced to clinical practice in many cities. In 1976, the first arteriovenous fistula was placed by Dr. Timokhov and Dr. Melikyan at the Moscow City Hospital n.a. S.P. Botkin, with arteriovenous fistula swiftly replacing shunts as the standard dialysis access technique in most HD units for ESRD patients soon after. The nephrology service in Leningrad first included HD units, working in cooperation with clinical nephrology and outpatient units; Professor Shostka coordinated this work.

During the next 2 decades, the number of HD units increased; however, they were insufficient to meet the demands of dialysis care for the ESRD patients. The biggest challenge for the dialysis service was the Spitak (Armenia) earthquake in 1988. At least 400 earthquake victims developed crush syndrome, and many of them with ARF were treated with HD. Most victims were evacuated from Armenia to Moscow and other major cities.

The economic changes following the collapse of the Soviet Union resulted in the substantial growth of dialysis care services. Unfortunately, this growth was not accompanied by the development of dialysis machine production, and now only imported equipment is used in the Russian Federation. While many intensive care units were equipped with dialysis machines that performed HD and continuous hemodiafiltration, the PD program for adult patients was started in 1995 to improve dialysis services; the first three units were opened in the Moscow City Clinical Hospital No. 52, Moscow City Hospital n.a. S.P. Botkin, and Moscow City Clinical Hospital No. 7, followed by Mariinskaya City Hospital, Saint Petersburg, and later in the other big cities. The PD unit of Moscow City Clinical Hospital No. 52 is actually the biggest in the Russian Federation.

In 2002, the Ministry of Health issued an order regarding “Excellence of Organization of Dialysis Care,” whereby public-private partnership implementation resulted in a rapid increase in the HD outpatient units. The International KDIGO and ERBP Guidelines concerning CKD and acute kidney injury were translated to Russian and widely implemented [ 30, 35, 36 ].

Evaluation of the disease spectrum of ESRD is based on the data from the Registry of patients on renal replacement therapy (RRT), started by the Russian Dialysis Society in 1998. The available individual data analysis is shown in Table 2 [ 37 ].

Causes of ESRD in patients on hemodialysis and peritoneal dialysis

The evaluation and management of patients receiving RRT include monitoring of dialysis dose and key quality indicators, blood pressure, body mass index, serum albumin, hemoglobin, total cholesterol, total calcium, serum phosphates, and parathyroid hormone. Comorbidities, treatment patterns, mortality, and survival are also evaluated on a regular basis. Patients on RRT receive antihypertensive medications, iron supplementation, erythropoiesis-stimulating agents, phosphate binders, and calcimimetics.

Transplantation

The first kidney transplantation from a deceased donor was performed by Dr. Voronoy in 1933 in Kherson (now a territory of Ukraine). While the procedure was not successful, the first ever attempt, published in 1936, enabled further developments [ 38 ]. The first successful kidney transplantation from a living donor, in this case a relative, was performed by Professor Petrovsky at the Russian Research Center of Surgery in 1965. In 1967, the National Medical Research Center of Transplantology and Artificial Organs n.a. V.I. Shumakov (then the Research Institute of Organ and Tissue Transplantation, first headed by Professor Solovyov) was created by Professor Petrovsky. Professor Petrovsky, along with Professor Solovyov and his group, published a book entitled “Kidney transplantation” in 1969 [ 39 ], when the program of kidney transplantation from deceased donors was initiated and widely implemented by Professor Shumakov, who headed the Research Institute of Organ and Tissue Transplantation for more than 30 years since 1974. The number of centers performing kidney transplantation exclusively from deceased donors increased over the next 2 decades. Professor Phyliptsev played a leading role in the implementation of kidney transplantation for almost 3 decades. In 1990, the first center for pediatric kidney transplantation was opened in the Russian Children’s Clinical Hospital.

In 1992, the federal legislation regarding “transplantation of organs and/or tissues” was introduced, whereby only direct relatives are allowed to donate kidneys for transplantation. Several regulatory documents have been released since the order addressing “regalement of brain death diagnostics” (2014). The program of kidney transplantation from living donors commenced in 1999 in the National Medical Research Center of Transplantology and Artificial Organs, headed by Professor Moysuk, who summarized the experience of the first 2 years in the article “Kidney transplantation from living relative donor” [ 40 ].

The first Department of Nephrology came from the Department of Internal and Occupational Diseases of the 1st Moscow Medical University n.a. I.M Sechenov (formerly known as the Faculty of Medicine of Imperator’s Moscow University, created in 1755), which started in 1930 and was headed by Professor Tareev from 1950. Under his leadership, nephrology became one of the main priorities, and in 1966 the Clinic of Nephrology, Internal and Occupational Diseases opened, merging the Department of Nephrology, the Department of Internal and Occupational Diseases, and the Nephrology and HD units. Between 1986 and 2017, the head of the Clinic of Nephrology was Professor Mukhin. In 1972, Professor Tareev initiated the Laboratory of Nephrology Problems, which was headed by his daughter, Professor Tareeva, from 1975 [ 41 ].

An educational course on hemodialysis at the Russian Medical Academy of Continuous Postgraduate Education (formerly the Central Institute of Medical Qualification, created in 1930) was initiated by Professor Kulakov in 1965, based at the “Laboratory of Artificial Kidney”. In 1982, this educational course developed into the first Department of Nephrology and Hemodialysis, headed by Professor Kulakov [ 32 ]. The Department was, and still is, based in the Moscow City Hospital n.a. S.P. Botkin; the close relationships between academia and clinical practice ensured the development of the field. Currently the Department is headed by Professor Ermolenko, one of the opinion leaders in the field, whose monograph entitled “Chronic Hemodialysis” was published in 1982 [ 42 ].

In 1996, the Research Institute of Nephrology was created at the 1st Saint Petersburg Medical University n.a. I.P. Pavlov (formerly the Women’s Medical Institute, and later the 1st Leningrad Medical Institute), with Professor Ryabov as the first director. The Institute of Nephrology merged the Course of Nephrology and Dialysis (later the Department of Nephrology and Dialysis, headed by Professor Eacayan), the Department of Internal Medicine (formerly the Department of Internal Diseases, created in 1914 and headed by Professor Lang from 1919 to 1921), and several laboratories with the clinical nephrology unit.

A course of “efferent therapy” was started in 1994 at the Saint Petersburg Medical Academy of Postgraduate Education (formerly the Imperator’s Clinical Institute, created in 1896). The course was later changed to the Department of Nephrology and Efferent Therapy and existed until 2011, when the Saint Petersburg Medical Academy of Postgraduate Education merged with the Saint Petersburg Medical Academy n.a. I.M. Mechnikov (formerly the Institute of Psychoneurology, created in 1907) under the name North-Western State Medical University n.a. I.M. Mechnikov.

In 2004, the Department of Nephrology, headed by Professor Tomilina, opened in the Moscow State University of Medicine and Dentistry (formerly the Moscow Institute of Medicine and Dentistry, created from the Moscow State Institute of Dentistry in 1949). This is a unique institution, providing postgraduate education in the fields of clinical nephrology, nephropathology, dialysis, and transplantation.

All of the abovementioned institutions provide professional education for residents and PhD students as well as certification courses and short-term continuing medical education (CME) courses.

The Society of Nephrology and Immunopathology, as part of the Moscow Scientific Society of Therapeutics created in 1895, started its work in 1958 and is currently active, conducts monthly meetings, and is devoted to selected issues of clinical nephrology, immunonephrology, and nephropathology.

The Scientific Society of Nephrology (SSN) was founded in 1969 by Professor Tareev, who was the President of the Society for almost 15 years. The congresses of the SSN have been conducted every 6 years since 1974, and during the intervening years Nephrology Summer Schools, initiated by Professor Natochin, the successor of Professor Gynetsynsky, were the most important events.

First contacts with ISN leadership were established by Professor Tomilina in 1994, when she invited Professor Brenner and Professor Dirks to attend the SSN meeting in Moscow. In 1995, the first CME course under the aegis of the ISN, ERA-EDTA, and IPNA was conducted in Moscow. The formal organizer was the SSN, but Professor Tomilina was the driving force. Among the invited international speakers were Professor Cameron and Professor Lameire. Unfortunately, due to formal official regulations the SSN was unable to continue its work for several years. The Scientific Society of Russian Nephrologists, the successor of the SSN, was started in 2005, conducting congresses and plenary assemblies and creating national guidelines and protocols.

In 1997, the Union of Pediatric Nephrologists was funded by an initiative of Professor Papayan [ 22 ]. In 1998, the Russian Dialysis Society (RDS) was established, with Professor Tomilina as the first president. This society is currently the most active professional society of nephrologists in Russia. It is affiliated with the ISN, ERA-EDTA, and EKHA, and cooperates with KDIGO, ERBP, and WKD leadership. The RDS is specifically dedicated to the education of nephrologists throughout the Russian Federation, and conducts up to five CME conferences each year in Moscow, Saint Petersburg, and the big cities in Siberia, Volga, Far East, North West, North, and South Regions. Numerous international leaders of nephrology deliver talks at these meetings as invited speakers, as well as conducting ISN Educational Ambassadors Courses. The RDS also supports the registry and the journal Nephrology and Dialysis (see below). Translations of most KDIGO and ERBP Guidelines and World Kidney Day Editorials were undertaken and published by RDS initiatives [ 26-30, 35, 36, 43, 44 ].

The first journal to publish papers with nephrology articles in Russian was Urology and Nephrology , which was started in 1968 on the basis of the Urology journal, issued since 1965. The journal Nephrology was started by Professor Smirnov in Saint Petersburg in 1997 and was the first journal to publish a wide range of articles in the field.

In 1998, the journal Nephrology and Dialysis (an official journal of the RDS) was initiated by Professor Tomilina. This journal is the most influential nephrology journal in Russia with one of the highest impact factors among all medical journals in Russia. The journal Clinical Nephrology was started in 2009, and was edited by Professor Mukhin till 2017.

In 1998, Professor Tomilina initiated the registry of patients on RRT. The registry data is published every other year in the journal Nephrology and Dialysis , providing detailed information about many aspects of RRT in Russia. These include information not only about the number of centers and patients, but also on issues of anemia, hypertension, CKD-MBD management, viral hepatitis diagnostics and treatment, and many other aspects. The registry is affiliated with the ERA-EDTA Registry, providing data for international publications.

The most recent analysis, which includes published data till the end of 2015 [ 45 ] and unpublished data up to the end of 2016, shows that the total number of centers providing RRT is 506 (including 466 providing HD, 111 for PD, and 37 for kidney transplantation), with many centers providing two or three modalities. Of note, only centers providing care to both adult and pediatric patients with ESRD were included, while centers providing care specifically to patients with acute kidney injury were not registered. The number of patients with ESRD on HD + PD by the end of 2016 was 44,771 (33,876 on HD, 8,537 on PD, and 2,358 living with transplanted kidney); the mean ratio was 305 per million inhabitants. Furthermore, the number of patients on HD in 2016 was 78% greater than that in 2010, mainly due to the development of public-private partnership.

Absence of nephrology courses for students in Medical schools

Relatively short-term professional postgraduate education (2-year residency, absence of fellowship programs)

Lack of certified nephrologists

Under-recognition of CKD burden by health authorities and policy makers

Under-diagnostics of CKD in the adult population

Lack of cooperation among nephrologists and general practitioners, endocrinologists, cardiologists, and other specialists

Under-diagnostics of CKD and ESRD in the pediatric population

Lack of nephrology units, disproportionate to the number of dialysis units, especially outside big industrial areas

Lack of renal pathologists and unavailability of kidney biopsy in many regions

Under-development of PD

Uneven distribution of dialysis service throughout the territory of the country, with several remote regions still poorly covered by RRT

Lack of transplantation and insufficient organ har vesting

Insufficient funds for research

Nephrology in Russia, despite currently experiencing many difficulties, made great advances during the 60 years of its development. General nephrology, nephropathology, and RRT 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.

The author thanks Dr. Anton Andrusev, Dr. Sergey Lashutin, and Prof. Natalia Tomilina for their valuable help.

No ethic approval is required for this type of study.

The author declares no conflict of interest.

Email alerts

Citing articles via, suggested reading.

• Online ISSN 2296-9357
• Print ISSN 2296-9381

INFORMATION

• Contact & Support
• Information & Downloads
• Rights & Permissions
• Terms & Conditions
• Catalogue & Pricing
• Policies & Information
• People & Organization
• Stay Up-to-Date
• Regional Offices
• Community Voice

SERVICES FOR

• Researchers
• Healthcare Professionals
• Patients & Supporters
• Health Sciences Industry
• Medical Societies
• Agents & Booksellers

Karger International

• S. Karger AG
• P.O Box, CH-4009 Basel (Switzerland)
• Allschwilerstrasse 10, CH-4055 Basel
• Tel: +41 61 306 11 11
• Fax: +41 61 306 12 34
• Email: [email protected]
• Experience Blog
• Privacy Policy
• Terms of Use

This Feature Is Available To Subscribers Only

Sign In or Create an Account