In 1991 the National Kidney and Urologic Diseases Advisory Board publi
shed a long-range plan entitled ''Window on the 21st Century. In that
plan the Board recommended that Congress establish a new National Inst
itute of Kidney and Urologic Diseases (NIKUD). This recommendation ste
mmed from the Board's appreciation that patient morbidity and mortalit
y from kidney and urologic diseases continue to increase and that a fo
cused, well funded research endeavor is the only real hope for reversi
ng this trend. In 1992 the Board established a special subcommittee to
consider further the establishment of a National Institute of Kidney
and Urologic Diseases. The subcommittee sought input from a wide varie
ty of extramural and intramural sources. American Urological Associati
on: A new devoted institute would provide coordination and expansion o
f basic research into kidney and urologic diseases now fragmented and
underfunded within multiple institutes. The research areas of kidney a
nd urologic diseases are not currently receiving adequate or appropria
te attention proportionate to their prevalence and their adverse impac
t upon society. American Society of Nephrology: The Society supports t
he establishment of a separate kidney and urology institute. First and
foremost, our primary interest is to obtain more support for kidney a
nd urologic diseases. Such research does not receive the emphasis and
prominence that it deserves at the National Institutes of Health. The
Society believes that a separate institute would provide increased foc
us for these diseases. National Kidney Foundation: The creation of suc
h an institute is the highest priority of the medical and lay constitu
encies of the Foundation. American Foundation for Urologic Disease: Th
e creation of a new (kidney and urology) institute within the National
Institutes of Health Is by far the most expeditious way to centralize
and advance the research efforts in this critical field. Scope of a N
ew Kidney and Urologic Diseases Institute: NIKUD should develop an int
ramural and extramural research program that focuses on all aspects of
kidney and urology diseases. NIKUD should be organized so that its ac
tivities address issues in pediatric and adult kidney and urologic dis
eases, including renal failure, transplantation, hypertension, diabete
s, cancer, incontinence, sexual dysfunction and male reproduction. NIK
UD must foster research training and career development. The integrate
d scientific programs of the new institute will enhance the treatment
and cure of kidney and urologic diseases. The development of this new
institute will improve the communication between the multiple discipli
nes involved in kidney and urologic diseases. The establishment of an
integrated relationship between kidney and urologic diseases research
will lead to the development of a unique scientific culture. A new ins
titute for kidney and urologic diseases will greatly enhance the recru
itment of bright, young physicians into kidney and urologic research.