(Nordic Nephrology Days)
May 11-14, 1997
University of Lund
Bengt Rippe, M.D.
Dr. Rippe is Professor of Medicine at the University of Lund which hosted the meeting.
The history of Lund
Lund is an old city that was founded over 1,000 years ago, just north of Uppåkra, which is in turn nearly 1,000 years older and presently subject to some archeological exploration. Already during the first century of this millennium, Lund became a cultural and economical center of the Danish empire at that time and one of the most important cities of Scandinavia. With the throne of the Archbishop of Scandinavia placed here from 1104 until 1152 and the erection of the Cathedral in the 12th Century, Lund became the religious capital of Scandinavia, at least during that era.
In 1658, Scania (Skåne) became part of Sweden, and Lund came under Swedish rule. Only a couple of years later, the University of Lund was founded, and today this is the biggest university in Scandinavia. I will already now mention that we tomorrow are going to have lunch at "Kulturen", and among other things, there is an exhibition on the history of the University of Lund there. I advise you to visit this exhibition.
Today the Örestad region, which includes the Lund-Malmö area and the Copenhagen-Roskilde area, has the highest concentration of researchers in Europe. The bridge that is presently being built between these two areas will hopefully not only become a physical connection between the regions but also a mental and cultural one. If this really becomes reality, there are good conditions for the Örestad area to become a very prosperous and flourishing part of Europe. The cooperation that is already started between the medical faculties of Lund and Copenhagen has therefore been denoted the "Medicon Valley Academy".
Brief history of the work of Nils Alwall
In the beginning of the 1940s, Nils Alwall in Lund performed animal experiments in which he proved the feasibility and technical applicability of a new treatment principle, namely extracorporeal blood treatment according to the dialysis principle. In September 1946, just a few years after Kolff's pioneering work in Kampen, in Holland, Alwall received permission to use hemodialysis in a critically ill patient with renal failure, using a technical device which he had constructed himself just a few years earlier.
Dr. Nils Alwall
The first dialysis unit
Later in 1946, or actually the beginning of 1947, the first unit in the world completely intended for dialysis was started in Lund. This later became a platform for the foundation of the first renal clinic, completely separate from the medical clinic and the first academic Chair ever in the world in nephrology, placed here in Lund, already in 1957.
By the way, it is a special pleasure to acknowledge the presence here today of Mrs. Ellen Alwall and her daughter. I'm very happy for that.
The role of Nils Alwall in the development of dialysis
What Alwall has meant to dialysis and dialysis development all over the world is probably well known to you all. Alwall, for example, pioneered the technique of ultrafiltration and actually introduced the principle of hemofiltration. However, Alwall was also the founder of nephrology in a more general sense. Professor Alwall performed the first renal biopsies in the 1940s, and he was instrumental in the formation of the Swedish Society of Nephrology in 1965 to 1967. During his lifetime, he constantly fought a battle against authorities in order to bring the necessary resources for the care and treatment of patients with renal disease. Professor Alwall had the privilege to experience during his lifetime a development of medicine, and particularly of nephrology and end-stage renal care, that has been almost revolutionary. In the 1940s renal failure, more or less invariably, ended with death. Today, various forms of renal replacement therapy enable patients to live a near-normal life.
How the Gambro Corporation was started
In 1961, Alwall, more or less by coincidence, met with Holger Crafoord at a party on the 12th night after Christmas at "Kulturen". To make a very long story short, this meeting ended up in the formation of the most successful companies in extracorporeal blood treatment in the world, namely Gambro. For obvious reasons there have always been good and close ties between this company and the Department of Nephrology in Lund. We gratefully acknowledge the support, in many ways, and the main sponsorship of this very meeting, from Gambro.
Collaborators of Nils Alwall
Alwall had a number of very good collaborators over the years, and I will mention just a few who worked closely together with Alwall during his pioneering period, and some of them are here today: Per Erlanson, Bengt Lindquist, Karl-Erik Hagstam, Carl Kjellstrand, Birger Lindergård, Horst Klinkmann, and last but not least Tore Lindholm, who, I am sad to say, passed away this year. His loss is deeply felt. There are a great number of other collaborators not mentioned here who also played a great role during the early period of development of dialysis and nephrology in Lund and in our country, and they are just too many to be mentioned.
Summary of this meeting
During the present meeting we will not only look back on the 50 years that have elapsed since Alwall's first dialysis treatment in Lund; we are all gathered here to discuss some very recent achievements in hemodialysis, as well as in peritoneal dialysis, and a number of other aspects concerning the treatment of end-stage renal failure, including metabolic aspects of renal disease and bone disease in transplantation. Tomorrow we will focus on renal physiology in the Tigerstedt Symposium, and on Wednesday there will be a symposium concerning renal inflammatory disease and vasculitis.
Already now I will take the opportunity to thank all collaborators who have contributed so much to the arrangements of this meeting. Above all I will thank Birger Lindergård, Anna-Lena Berg, and Mårten Segelmark from my staff and our department; and I also want to thank Karl-Axel Axelsson and Ingrid Ledebo at the Gambro company. My secretary, Kerstin Lindblad has also contributed; and, of course, our conference hostess Veronica Hallbäck). Finally, I wish to convey my deep gratitude to all sponsors for generous support of this meeting.
I do hope that we will have a successful conference and enjoy a relaxed and pleasant atmosphere here in Lund over the next couple of days. I noticed that for the for first time this spring, the magnolia have burst into blossom. I consider this to be a good sign. So, most welcome to Lund!
History of Dialysis: Men and Ideas. (Dr. Carl-Magnus Kjellstrand)
Renal Therapy in Lund: Homage to Nils Alwall. ( Dr. Horst Klinkmann )
Alwall Lecture: Urea kinetics during hemodialysis: practical implications of the regional blood flow model. (Dr. John T. Daugirdas)
Cardiovascular risk factors in renal disease. (Dr. Robert N. Foley)
Pathologic features, nomenclature and diagnosis of small vessel vasculitis. (Dr. Charles Jennette, M.D.)
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