Kidney, patient and new millennium nephrology

The way nephrology develops in the new millennium is bound to be affected b y changes in the nephrologist's clinical environment, as well as by the pro gress made in basic research which will need to find a clinical application . The nephrologist can expect to be more and more involved in renal substit ution therapy, not just providing the treatment, but also managing the cost of the service. In the field of nephropathology, the highest expectations surround molecular biology and its application to both acquired and heredit ary renal disease; the goal is to find an outlet for gene therapy in clinic al practice. Artificial substitution therapy will focus chiefly on the proj ect of 'intelligent dialysis', whereby biological and diagnostic components are combined according the specific needs of the individual patient. The i deal scenario for renal transplantation in the coming millennium would be o ne where donor supply matches the demand (xenotransplant?), where immunomod ulation is perfected, and where diagnoses are based on precise biomolecular events observed in real time. Copyright (C) 2000 S. Karger AG, Basel.