The holiday season is over, and my travelling schedule is back in full swing. I am just back from my first port of call for 2013 - Taiwan. And it was my first visit there - a memorable trip, thanks to a very warm welcome from ISN Councillor, Chih-Wei Yang, and his colleagues.
There is a danger that as ISN President I will dash from one event, conference call or airport to another without taking time to draw breath and reflect on what is happening in and around ISN, celebrate the achievements and better define challenges.
One of the often ignored challenges facing the ISN President is ‘climate change’! I left the UK last week in midwinter – a sprinkling of snow, and temperatures of 5C°. And the next day arrived in Ahmedabad for the annual congress of the ‘other ISN’ – the Indian Society of Nephrology. It was midwinter there as well …. 25C°, perfect blue skies, warm enough for dinner to be served outside in the evenings!
As always, most of my free time at ASN Renal Week in San Diego was consumed by ISN Committee meetings. The most rewarding for me were the discussions by the GO Core Committee around selecting recipients of the new ISN Pioneer Awards. The Pioneer Awards are a bit different from the usual awards that go to people who have done the best or most of something.
These awards are designed to honor previously unrecognized, or under-recognized, individuals who have made pioneering contributions to the development of nephrology in their respective countries or regions in the developing world, but who were not visible internationally. Identification of such individuals has required considerable beating of the bushes and input from our regional committees who know their local nephrology pioneers in a way that we as ISN leaders cannot.
Many have been nominated for the awards and one recipient will be selected for each region to be honored at the World Congress of Nephrology (WCN) in Hong Kong. Their stories, as might be anticipated, are quite moving portraits of a generation of dedicated people who often overcame considerable obstacles to make renal care or training available in places where none existed before. The inaugural Pioneer Award recipients will be honored and their stories capsulized on individual posters that will be displayed in a "GO Gallery" at WCN. I know everyone who takes the time to visit the display will find these people and their stories a particularly inspirational part of the overall WCN experience.
For several years the Asian Pacific Society of nephrology (APSN) has partnered with ISN to offer ISN-APSN Fellowships. The Executive Committee of APSN recognizes the importance of other programs within ISN Global Outreach Programs (GO) and so has offered to partner with ISN from 2013 in its other GO programs as well: CME, Education Ambassador, Research & Prevention, Sister Renal Centre. These sorts of partnerships make sense because the mission of ISN and APSN (and other regional societies) are closely aligned, unnecessary duplication can be avoided and valuable resources can be stretched further. It is a good model for other regional and national societies to consider!
Just back from a great trip seeing GO in action in Russia and Belarus. And in particular seeing the power of the Sister Renal Center program.
First to Minsk in Belarus, whose Sister Center link with Oxford, UK has now ‘graduated’ from the Sister Center program. The Sister Center development has been a key factor in transforming kidney care in Belarus over the last few years with more dialysis facilities and a very rapid growth in transplantation. But make no mistake though ISN can facilitate many things, it is the fine leadership of Aleh Kalachyk in Minsk and Paul Harden in Oxford which is at the heart of the success.
There is no doubt that in the past few decades Chinese nephrology has made impressive advances regarding know-how, infrastructures, education and training for young doctors caring for patients with kidney disease as well as in clinical and experimental research.
These achievements reveal the ability of Chinese nephrologists to address, at different levels, the issue of chronic kidney disease (CKD) in China with the same instruments currently adopted in Japan, Europe and USA. This is a relevant problem for China’s health system since the country is experiencing a huge CKD transition, with unprecedented social and environmental change.
It is just over a year ago that the United Nations High Level Meeting on Non-Communicable Diseases (NCDs) was convened in New York (September 19-20, 2011). This came at the end of an intense period of ISN activity – many ISN members finding opportunities to influence their health ministers to ask for an increased emphasis at that meeting on the importance of kidney disease as a major NCD.
I will admit that August was rather quiet for me – as always plenty of ISN business to keep me on my toes from my office at home, but four whole weeks without getting into a plane! But now things are in full swing.
An ISN leadership team began a trip to South East Asia by conducting the first ISN GO Oceania/South East Asia (OSEA) Regional Workshop on September 11, 2012, held in conjunction with the International Society of Peritoneal Dialysis meeting in Kuala Lumpur.
As I participated again in the ISN GO CME portion of the "Forefronts in Glomerular Disease - Nanjing Forum" meeting in Nanjing on August 25, I could not help being reminded of the first such event. It was called the "International Workshop on Renal Diseases" held at Jinling Hospital and Nanjing University in June 1988.
At that time, several ISN leaders including Robert Schrier from the US, Stuart Cameron from the UK and Priscilla Kincaid-Smith and Robert Atkins from Australia went to Nanjing at the invitation of the late Lei Chi Li, later an ISN Councilor and Honorary Member, who had personally organized the first ever nephrology meeting held in China with international speakers presenting in English. The enormity of that task was brought home the next year when the events in Tiananmen square in Beijing led to cancellation or postponement of follow up renal meetings in China.
But the seeds have been sown, and the Nanjing Forum has been held and supported by ISN almost every year since. The forum is unique among ISN CME events for reasons beyond its historical distinction of being the first ever international nephrology meeting in a modernizing China. It has always presented state-of-the-art renal science. This year it focused on newer aspects of podocyte function and systems biology mixed with clinical presentations and local speakers. The audience of 500-600 Chinese registrants also exceeds that of most CMEs and rivals an ISN Nexus or Forefronts meeting.
The high quality of the Nanjing meeting (now organized by ISN Councillor Zhi-Hong Liu, Director of the Research Institute for Nephrology at Jinling hospital) parallels the incredible growth of China itself over the past 20 years and the accompanying emergence of world class nephrology clinical care and research in Nanjing as well as in Beijing, Shanghai, Guangzhou and other large cities.
Over 20 years of ISN CME, fellowship and Sister Renal Center support for the Nanjing programs, along with the visionary leadership of individuals like Lei Chi Li and Zhi-Hong Liu, have been essential to making this program the center of excellence it is today. The challenge for the future will be using the Nanjing model to extend these same programs to more rural and much less developed renal centers in China.
I recently read the article by Harris et al. in Kidney International about the impact of the ISN Global Outreach (GO) Fellowship Program. The training of 545 nephrologists from 83 developing countries is quite remarkable. I was on the ISN Executive Committee as Treasurer when this program was launched and the goals of this Fellowship program have been more than realized.
On a recent trip to the Baltic countries, I again realized how important the ISN Fellowship Program was. The President of the Estonia nephrology program, Professor Mai Ots Rosenburg, is a former ISN fellow. She has played a major role in developing nephrology in Estonia. Another former ISN fellow, Dr. Marius Miglinas, is Chief of Nephrology in Vilnius, Lithuania and has been an important force in the development of nephrology in that country. Dr. Harris’ excellent review of the many such successes of the ISN Fellowship program is inspirational.
Japan is the country with the third largest ISN membership, and the Japanese Society of Nephrology (JSN), through the efforts and commitment of its leaders, has over recent years become a strong and supportive affiliated society of ISN.
I arrived in Paris on 24th May for the ERA-EDTA Congress just as summer began –warm sunshine and blue skies. However I saw very little of this beautiful city because I spent most of the 3 days I was there in meeting rooms – such is the life of the ISN President! And I only managed to get to one scientific session of the congress – the one in which I was speaking. Sally in the ISN office is always asking me for photos to post with my blog – but none this time - pictures of the inside of meeting rooms are not very interesting!
The Canadian Society of Nephrology met in St John’s Newfoundland, for our first meeting after the WCN 2011 (April 25 to 28, 2012). The membership was thankful to the ISN for the opportunity to host the WCN in Vancouver as well as showcase Canadian hospitality and science.
I am just on my way home from Colombia where SLANH (Sociedad Latinoamericana de Nefrología e Hipertensión) held its biennial Congress – just over a thousand nephrologists from all over Latin America were registered. Even the locals thought it was hot, 35 degrees and humid. How did we ever function without air conditioning?
THE WORLD BANK on Tuesday selected as its next president Dr. Jim Yong Kim, a Korean-American global health expert and president of Dartmouth College.
As part of its evolving online education strategy and to support its members in the developing world, ISN has developed a new feature on its website called “Global Outreach Postings”. ISN members from emerging countries are invited to submit manuscripts for review and, if suitable, publication on ISN’s website.
I’m on the way home from the Jordan Society of Nephrology annual scientific meeting where I was invited as an ISN-sponsored speaker by Norbert Lameire (from Belgium, and of course chair of the ISN GO CME program) and Patrick Niaudet (pediatric nephrologist in Paris).
As ISN leaders, we often talk of the many opportunities offered by the five ISN GO programs and the importance of fully integrating these programs with the activities of our eight Regional Committees to advance the development of nephrology worldwide. I recently had a unique opportunity to see this vision play out to the benefit of a young potential nephrologist in the Middle East.
March 8, 2012 is Wolrld Kidney Day. This year we are focusing on the importance of kidney transplantation and donation, spreading the word on the effectiveness of this form of treatment. The last 50 years have seen the development of new medications and approaches - improving the lives of kidney transplant recipients. The importance of including transplantation as a treatment option for all cannot be overstated. Nonetheless, the legacy of transplantation is unfortunately threatened by organ trafficking and transplant tourism.
On my way back from Shanghai where ISN co-sponsored KDIGO’s first clinical practice conference. It was the end of the Chinese New Year Festival – this is the year of the dragon – so Shanghai was full of colourful tributes (see picture). This also meant it was a holiday weekend, so the Shanghai roads were quiet by their usual standards!
In a stunning development, Novartis said Tuesday that it will terminate the late-stage ALTITUDE study investigating Rasilez (aliskiren) in patients with type 2 diabetes and renal impairment on the recommendation of an independent data monitoring committee.
Read more on our partner site UKidney
As I leave Dubai following the ISN Update Course in Nephrology and the first ISN GO Regional workshop for the Middle East region, I am again struck by the enormous benefit we derive from talking directly to our members and potential members in the areas where they live and work.
I always knew my short trip to Iran would be interesting and important – but did not expect it to be quite exciting as it turned out.
Our flight from London to Tehran could not land as a sudden swell of fog closed the airport. After some optimistic circling we retreated to Yerevan in Armenia where we found ourselves at 6am filling in applications for 24 hour visas, and eventually getting to a hotel for some rest. 18 hours later, we were heading back to the airport but had to sit at the roadside for an hour while our coach driver and the driver of the car which our coach had ‘contacted’, had a long loud argument about whose fault the collision had been... you did not need to understand any Armenian to know they were not agreeing!
On behalf of the ISN Executive Committee, I am delighted to announce that Detlef Schlondorff has been appointed as the new Editor in Chief of Kidney International (KI), to succeed Qais Al-Awqati in early 2012. Detlef has had a long association with both ISN and Kidney International, lately as Associate Editor. Currently, he is Professor Emeritus of the Ludwig Maximilians University in Munich and Visiting Professor at Mount Sinai School of Medicine in New York. He has exciting plans for KI, and a clear vision for its future. KI has flourished under Qais, and will go from strength to strength under Detlef. ISN’s flagship is in good hands!
I just returned from the first ever ISN Global Outreach (GO) Continuing Medical Education (CME) course in Lusaka, Zambia. The ISN GO CME delegation included myself, Bill Couser, Chair of ISN GO, Sarala Naicker, Chair of the GO Educational Ambassadors Program and Andre Weigert from Lisbon, a member of the Africa Regional committee.
Only 10 days ago, I was listening to Ray Vanholder from Belgium, Chair of ISN's Disaster Relief Task Force, presenting at the BANTAO Congress in Greece about the work of the Task Force and the challenges of disaster nephrology and crush syndrome. And now, once again, the need is a reality as a major earthquake has struck Eastern Turkey.
Welcome to the first in my new series of blog posts. I want to take the chance to regularly share with you some important ISN issues and update you on new developments inside and outside ISN.
And I also thought you would be interested to know how the ISN President keeps busy!
There is really not enough space to describe all the history of kidney research and care in China. In Beijing alone, five short-term ISN visiting scholars and six ISN Fellows have contributed to kidney disease care and research in China.
I was honoured to join an ISN Continuing Medical Education course in Beijing, which focused on clinical trials methodology and clinical research initiatives. Most impressive was the attentiveness of the audience, the enthusiasm of the speakers and the context of this initiative.
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