You never stop learning, even in the coldest winters

The upcoming winter will be cold. This will not have to do with global warming, but with the current economic crisis and the Russia-Ukraine war, which has led to an unprecedented rise in the price of fuel.

A note from France’s Haute Authortité des Soins (Ministry of Health) was recently delivered via the Hospimedia network, informing hospitals that they should brace themselves for energy blackouts, expected to begin in early December.

“What next?” one might ask. The nephrology community, like the larger medical community, demonstrated great resilience in its response to the COVID-19 pandemic, medical migration and an economic crisis with health and food insecurity. Will we spend this winter wrapped in blankets, keeping warm, while reading and writing science?

What will we learn from the challenges that lie ahead?

Meanwhile, let us learn from the current ones.

In this issue we focus on two opposite age groups.

We present papers on how to manage women with chronic kidney disease in pregnancy to ensure that complicated pregnancies do not endanger kidney health.

We face many challenges. First of all, pregnancy, the mystery of life beginning, is also a mystery in terms of health. Obstetric nephrology is still underdeveloped and its perspective, often prevention-oriented, is not easily integrated with time constraints, or guidelines that still suggest nephrologists should limit their interventions to cases of advanced CKD.

Elderly patients also pose numerous challenges. In dialysis and CKD, at least in Europe, fragile elderly adults now constitute the majority of patients on follow-up.

The changing concept of old age is intriguing.

In nephrology, the definition of an elderly patient with respect to dialysis and transplantation has steadily increased by almost 1 year per year. While until the late eighties, “old” meant “50 and up”, it now means “over 80”. Defining old age solely on the basis of numbers is now being challenged, acknowledging the fact that clinical heterogeneity also increases with age, and some authors have proposed using a “biological” definition, based on frailty. If we accepted this, we would move a step closer to individualized medicine.

This issue also includes reports on the experiences of colleagues working in distant places, demonstrating that under the pressure of epidemics, wars, or even “just” a lack of resources, it is the ability to adapt that enables us to solve problems. We applaud their achievements and thank them for sharing their stories, allowing us to learn from how they have overcome obstacles.

A quote from Nelson Mandela on the subject of resilience is what we hope will be true of us all: “A winner is a dreamer who never gives up”.

留言 (0)

沒有登入
gif