Introduction

“In the last two centuries major contributions to renal physiology and clinical medicine had been made in the German-speaking world. Key observations in our specialty were reported by several outstanding scientists and clinicians in Germany and neighboring German-speaking countries” [1]. In 1842 Carl Ludwig introduced the concept of glomerular filtration and the reabsorptive and diffusive processes in the tubule. In 1862 Jacob Henle described the loop of Henle [1]. In 1909 the structure and arrangement of the nephron as well as the macula densa cells were characterized by Karl Peter [2]. In the beginning of the 20^th century Volhard and Fahr (1914) established a novel classification of renal diseases and hypertension [3]. In 1924 the first human hemodialysis treatment was performed by Georg Haas [4].

In the 1950s a real breakthrough occurred in clinical nephrology and basic research of the kidney. The pioneer inventions included measurement of GFR and tubular functions by Homer Smith (1951) [5], percutaneous renal biopsy (Iversen and Brun 1951) [5], description of the analgesic nephropathy (Spühler and Zollinger 1953) [6] and hemodialysis treatment of acute renal failure (Kolff 1948, Alwall 1952) [5]. Great progress of basic research included description of the concentration process in the kidney by kryoscopy [7], the introduction of new micropuncture techniques and microanalytic methods to evaluate the function of different parts of the nephron [8]. Based on such progresses, a number of national societies of nephrology were founded.

At the 1^st Congress of the International Society of Nephrology (ISN) in Evian on September 3rd 1960, a small group of nephrologists from Germany, Switzerland and Austria decided to establish the Society of Nephrology [9] [10]. It was founded on April 10^th 1961 in Wiesbaden. The first president was Professor Hans Sarre (Freiburg i.Br), a scholar of Franz Volhard and the Vice-President Professor Kurt Kramer (Göttingen), the “father” of renal physiology. Dozent Klaus Rother (Freiburg i. Br.) was the secretary and board members were Professor Francois Reubi (Bern), Professor Wolfgang Dutz (East-Berlin), Professor Ernst Wollheim (Würzburg), Professor Bruno Watschinger (Vienna) and Dozent Karl Ullrich (Göttingen). A picture of the founders is shown in Figure 1.

The society was a true scientific academic organization with the primary goal of an intensive interaction between basic science of the kidney (anatomy, physiology, pathophysiology, pathology, molecular biology and pharmacology) and clinical research in nephrology and hypertension. Prerequisites for membership were scientific publications and support by two members of the society. The primary venture of the society was an annual scientific symposium held in different places of the three countries. The presidents were elected for one year and organized the scientific program of the symposia. The secretaries stayed for several years to guarantee the continuity. The presidents and the places of the symposia as well as the secretaries are listed in Table 1 and Table 2.

The main topics of the first five symposia were “Acute Renal Failure” (Freiburg 1961), “The Nephrotic Syndrome” (Bern /CH) 1962), “Normal and Pathological Functions of the Kidney Tubulus” (Berlin 1964), “Current Problems in Nephrology” (Homburg /Saar 1965) and “Progress in Nephrology” (Lausanne /CH, 1967). These symposia were published as books [11] [12] [13] [14]. From 1979 to 1992 the main lectures were published in the “Klinische Wochenschrift” and in the next 2 years in the “Clinical Investigator”. From 1995 to 2004 the main lectures were published in “Kidney and Blood Pressure Research”.

The scientific strength of the society was based mainly on outstanding scientists in basic research in physiology, anatomy, pathology and pharmacology (Figure 2 and Figure 3, key clinical nephrologists are shown in Figure 4). 

In the 1960s-1980s clinical nephrologists were mainly involved in the time-consuming organization of haemo- and peritoneal-dialysis as well as kidney transplantation which shortened the time for scientific research. In spite of clinical work, many clinical nephrologists made important scientific contributions in their field.

Working Group of Clinical Nephrology

The Society of Nephrology in the first two decades addressed preferentially scientific projects. There was however a need for a forum to deal with all practical issues in clinical nephrology. For this reason the “Working Group of Clinical Nephrology” (Arbeitsgemeinschaft für klinische Nephrologie) was founded in 1971 [15], to address specialized and subspezialized practice in nephrology and also different forms of dialysis, hemodialysis access as well as renal transplantation [15]. Training programs for clinical nephrologists and dialysis personnel were established. During the first two decades specific meetings took place in the intervals between congresses of the Society of Nephrology. It was the merit of Heini Murer to organize parallel sessions of both the Society of Nephrology and the Working Group of Clinical Nephrology on occasion of the congress of the Society of Nephrology in Zürich 1994.

Joint Meetings of the Society of Nephrology with Foreign Societies

There were two Joint Meetings with the Dutch Society of Nephrology: The first was held in Leiden in February 1985. Organizers were A.J.M. Donker (Amsterdam) and W. Thoenes (Mainz). The 2nd Joint Meeting took place in Aachen, in September 1997. The organizers were H-G Sieberth (Aachen) and J.H.M. Berden (Nijmegen).

Two meetings with the Israel Society of Nephrology occurred in Jerusalem in November 1988, on occasion of the 40th anniversary of the state of Israel with Jacques Bernheim (Kfar Saba) and August Heidland (Würzburg) chairmen and the second one in Weimar, May 1992 with the Organizers Jacques Bernheim (Kfar Saba) and Günter Stein (Jena) chairmen [16].

Evaluation of Clinical Nephrology at German University Clinics by the American Kidney Foundation

In contrast to the outstanding basic research on the kidney in the early dates, clinical nephrology at universities suffered from considerable structural deficits in our country. Until the end of 80s only eight chairs of nephrology and 6 independent divisions of nephrology existed in Germany. At ten universities the work of clinical nephrology was taken care of only by one or two nephrologists in dependent positions. Therefore, Eberhard Ritz during his time as president of our society suggested in 1991 that the National Kidney Foundation (NKF) of the US should be invited for a critical evaluation of clinical nephrology at the universities of our country. For this purpose two officers of the NKF, Prof. Shaul G. Massry and Prof. Richard J Glassock, discussed this problem with the leading nephrologists of our society in October 1991 in Frankfurt, subsequently they visited seven university clinics in West and East Germany. Based on these observations, they made detailed recommendations to improve the levels of clinical nephrology both in terms of research and patients care [17]. Their report, together with a statement of the Society of Nephrology, was addressed to all Ministers of Sciences and the Deans of Medical Faculties in our country. The action was successful and resulted in the foundation of further seven chairs of nephrology [17].

Advisory Board (Kuratorium) of the Society of Nephrology

Peter Weidmann (Bern) organized the establishment of a “Kuratorium” to attract sponsors from the pharmaceutical industry. The goals of the Kuratorium were, among others, the organization of Update Seminars in Eastern Europe (1994-1998), the participation in the Joint Action of Nephrology in Eastern Europe, the Eastern European European Scholarship Program for Junior Clinical Nephrologists and Public Relations Work. The Update Seminars in Eastern Europe were organized with the presidents of the following foreign societies: Polish Society (President František Kokot) in Wisla [18], May 1995, Romanian Society (President Jancu Sabo) in Timisoara, October 1995, Russian Society (President Yuri Natochin) in St. Petersburg, May 1996, Bulgarian Society (President Zdravko Kiriakov) in Sofia [19], October 1996, Slovenian (President Marko Malovrh) and Croatian Society (President Sabljar Matovinovic) in Brdo Pri Kranju [20], November 1997, Ukrainian Society (President Lyubomir Pyrih) in Kiev [21] (full text), May 1998 and Slovakian Society (President Rastislav Dzurik) in Bratislava [22] (full text), November 1998 [16].

Joint Action of Nephrology in Central and Eastern Europe

With the International Society of Nephrology, the European Renal Association and the Kuratorium Joint Actions of clinical nephrology Eberhard Ritz organized conferences in the following countries: In Kaunas (in cooperation with the three Baltic states Estonia, Latvia and Lithuania, May 1996), in Budapest (together with the Hungarian Society of Nephrology on May 1966) and in Cracow (in cooperation with the Polish Society of Nephrology August 1997). The Update Seminars and the Joint Action in Eastern countries as well as the European Scholarship Program program were great successes by bringing many scientists together and by resulting in long lasting connections.

Nephrology in the former German Democratic Republic (GDR)

The initially promising connection with nephrologists from GDR after the foundation of our society came to a sudden halt after the Iron Curtain was built in August 1961. Scientists and clinicians in East Germany were no longer allowed to be members of our Society. Only few nephrologists from GDR could subsequently take part in congresses in Germany only after personal invitation. The best chances to obtain allowance to visit our meetings were congresses in the neutral countries Switzerland or Austria. Particularly, Gilbert Thiel in Basel strongly supported participation of numerous GDR nephrologists [23]. After the fall of the Wall, the GDR Society of Nephrology was connected with the Working Group of Clinical Nephrology. Together they formed the German Working Group of Clinical Nephrology.

Foundation of the German Society of Nephrology

In the late 1990s and the beginning of the 21^st century, the Society of Nephrology, together with the Kuratorium, made progresses in many different fields of nephrology  including the public relations. Of importance was the assignment of a press officer (Professor J. Galle). The number of the members of the Society reached more than 1100 in 2008. Despite these successful developments of our Society in nearly five decades, there was a need to combine all nephrological activities in one organization, the German Society of Nephrology (DGfN). Therefore in 2009 the DGfN was founded by merging of the Society of Nephrology with the German Working Group of Nephrology and the corporative membership of the Society of Pediatric Nephrology and the Association of German Kidney Centers [24] [25]. The goals of the new society were: support of research, education and training, achievement of optimal care for patients with kidney diseases and hypertension, and strengthening nephrology as a field of medical specialization. Numerous commissions were established e.g. for public relations, dialysis machines, transplantation, hygiene and infection and science. The board of the DGfN included equal members from university clinics, general hospitals, practicing nephrologists and scientists.

The first leadership of the society was: President R. Brunkhorst, and four Vice Presidents J. Floege and Ch. Erley (representative of nephrologists in general hospitals and university clinics), K. Amann (representative of basic science institutes) and Th. Weinreich (representative of practicing nephrologists) [24] [25].

Summary

Nearly five decades of the Joint Society of Nephrology in Germany, Switzerland and Austria were remarkably effective in promoting basic research and clinical nephrology. In 2009, the German Society of Nephrology (DGfN) was founded to integrate all areas of basic research of the kidney and clinical nephrology in one society which has impressively flourished ever since.