A large part of the work that nephrologists have to cover \nin their daily practice is related to uraemia, renal replacement \ntreatment by dialysis or renal transplantation, \nincluding the complications of chronic kidney disease \n(CKD) and side effects of the treatment modalities. This \nis the heart of our speciality, and it is not likely to be \nmissed in the future. The area of origin of renal diseases \nand mechanisms of initial damage and further progression, \nin native kidneys as well as in transplanted grafts, \nis a field which has lost some of the pioneer enthusiasm \nthat brought the science of nephrology to the medical \nscene some decades ago. The scenario is getting larger, \nand the nephrologists must maintain this area as a priority \nfor research, in spite of increasing difficulties. Genetics is \ngoing to cover a relevant area, but the complexity of the \ngenetic background needs a clinically oriented mind to \nlead to concrete advancements. Most renal diseases develop \nbecause of a deranged immune system, on a genetic or \nacquired basis. Thus, as much as we need good collaborations \namong disciplines, we should maintain an active \nrole in both genetics and immunology and not give \nup these fields. In addition, as much as networking \nwith these colleagues is fundamental, our clinical resources \nwill allow the most relevant progress. The understanding \nof pathogenetic mechanisms is getting more \nand more difficult, and often clinicians are reluctant to \nspend time in an apparently useless mental exercise. \nHowever, nephrologists cannot help updating in this area \nto provide the best results for the most patients with renal \ndiseases. \nThe establishment of the Immunonephrology Working \nGroup of the European Renal Association-European \nDialysis and Transplant Association (ERA-EDTA) is a \ngood opportunity to focus the interest of nephrologists in \nEurope on this field, which has several relevant outstanding \nrepresentatives but is obviously much less numerous \nthan other groups interested in dialysis or chronic kidney \ndisease complications, like anaemia and bone disease. Immunopathology \ncovers an area which can further increase \nthe visibility of the nephrological work with benefit for the \nwhole nephrology community. \nAworking group of the ERA-EDTA devoted to immunonephrology \nhas been started up in 2009 to encourage \nresearch, teaching and communication of knowledge in \nthe field of immune system dysregulation as a factor \nfavouring the development and progression of renal diseases \nand as a target for appropriate therapy. \nIt includes: \n–Glomerular, tubular and vascular immuno-mediated \nrenal diseases \n–Immune mechanisms in pathogenesis and progression \nof renal damage \n–Immune-mediated damage in kidney transplantation
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