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History of Nephrology in Iran
Nephrology has a very long history in Iran. Abu-Bakr Mohahammad-Ibn Zakariya Razi (Rhazes) (865-925 AD), the Persian physician, philosopher and chemist, can be considered as one of the pioneers in nephrology. Rhazes wrote several medical textbooks including “Les observations cliniques”,discussing the course and progression of different diseases. This textbook contains 17 case histories, six of them about patients with renal disease and one about a case of preeclampsia.

Avicenna (980-1037 AD) was one of the scientists who performed urinalysis in a scientific method. In his famous textbook, the Canon of Medicine, Avicenna has described urinalysis in 30 pages. Indeed his interpretation of the findings in urinalysis is very impressive: “If a limpid urine is dark and a deposit is suspended in it in different layers, this denotes cephalgia, wakefulness, deafness and mental confusion. Such urine shows that epistaxis is pending”. This sentence can be considered as a description of uremia due to progressive hereditary nephritis (Aloprt’s syndrome).

Development of medicine declined in Iran since transfer of the University of Jondi Shapour (one of the old cities in south of Iran) to Baghdad. In about 75 years ago, modern medicine started in Iran with establishment of the faculty of Medicine in Tehran University. In those days there was no definite field of medicine as nephrology and renal patients were managed in general medical wards by the internists, especially those trained in France.

The first Persian textbook of renal diseases was published Dr. Nouredin Hadavi in 1958. Modern nephrology started in Iran in mid 1960s, when a number of internists trained in nephrology in France, United Kingdom and United States, returned to Iran. These physicians established an association that founded the first Iranian Society of Nephrology (see About IrSN >> IrSN History) .From 1969 a number of the beds of the internal medicine wards were allocated to patients with renal diseases and the practice of nephrology gradually expanded throughout the country.

In Iran the first hemodialysis was performed for the management of a patient with acute renal failure on 1960 at Tehran University, utilizing the Kolff Rotating Drum kidney. Before that time only acute peritoneal dialysis was available for treatment of renal failure patients. Chronic hemodialysis program started and gradually expanded between 1967 and 1976 at several private and university hospitals. With establishment of an ESRD office at the ministry of Health (now called Management Center for non-contagious and special diseases- MCNS) on 1976, dialysis facilities expanded throughout the country. At present, according to the latest data obtained from MCNS (Dec. 2008), 16,600 patients are under chronic hemodialysis in 355 dialysis wards throughout the country.

The first kidney transplantation was performed in Shiraz University in 1968 from a living unrelated donor and the first cadaveric renal transplantation was done 4 years later. Renal transplantation program has also expanded in a large scale during these years, with 26 transplantation wards throughout the country, mainly located in University hospitals. During these years more than 24,770 renal transplantations have been performed in Iran and at present 16,150 patients live with functioning renal allograft.

Chronic peritoneal dialysis program was started on 1978, but its rate of expansion has been lagging far behind the hemodialysis and transplantation programs due to several socioeconomic and programming reasons, beyond the scopes of this text. At present we have 1100 peritoneal dialysis patients under follow-up in 42 CAPD wards in the country.

(Updated: Dec. 2008)