The articles were prepared by leading Polish specialists within nephrology and transplantology with contributions from the promising generation of young doctors.

Professor Bolesław Rutkowski presents an outline of the history of Polish nephrology and the current scientific position of Polish academic nephrology based on a survey carried out for the Polish Academy of Sciences (PAN). The presented data show that the general position of Polish nephrology within academic and research activity is very good. If there were greater funds available for our research, it would be even better.

Dr. Aureliusz Kolonko and Prof. Andrzej Więcek present in their article issues connected with the application of Doppler ultrasonography in patients after kidney transplantation, which is undoubtedly commonly used as a non-invasive method. The authors describe recommendations for this examination, interpretation of results, diagnostic and prognostic value, and also limitations of this method.

Dr. Małgorzata Zynek-Litwin and Prof. Jakub Kuźniar as well as Prof. Marian Klinger describe the role of neutrophils in development of ischaemia-reperfusion injury of the transplanted kidney. Ischaemia-reperfusion injury is an important non-immunological factor influencing the early and long-term function of the kidney transplant. The authors present mechanisms in the course of which neutrophils stimulated by the produced oxygen free radicals and proteolytic enzymes damage the transplanted organ.

Professor Joanna Matuszkiewicz-Rowińska deeply and broadly presents the problems of renal replacement therapy in patients with acute kidney damage. This is still a group of patients burdened with a great mortality risk. The author presents a review of currently used techniques of renal replacement therapy (continuous techniques, hybrid techniques, peritoneal dialysis, intermittent haemodialysis), and describes therapy results concerning the moment of therapy initiation and dialysis doses. We do not have an unambiguous answer to the question of how intensively the patient should be treated. A lot depends on the capabilities and experience of the centre.

Professor Jolanta Małyszko and Professor Jacek Małyszko describe the most commonly occurring cancers of the urinary system in kidney recipients, their epidemiology, screening and treatment methods. Over 90% of cancers develop de novo after the kidney transplantation. The most common cancer of the urinary system in kidney recipients is native kidney cancer.

Dr. Anna Zawiasa and Professor Michał Nowicki present issues concerning the occurrence of metabolic syndrome in kidney transplant recipients. This is a group of patients with an increased cardiovascular risk that consists of hypertension, obesity, lipid disorders and glucose intolerance. The metabolic syndrome is not only a risk factor of cardiovascular complications but also of worse survival of the kidney transplantation.

Dr. Dominika Dęborska-Materkowska and Professor Magdalena Durlik summarize the current state of knowledge on epidemiology, pathogenesis, diagnosis, prevention and treatment of recurrent focal segmental glomerulosclerosis in transplanted kidneys. Due to the frequent, early recurrence of severe nephrotic syndrome, the treatment of this disease is a great challenge for a transplantologist.

A team from Szczecin – Dr. Anna Misiewicz, Dr. hab. Jacek Różański, Dr. Małgorzata Marchelek-Myśliwiec and Dr. Magda Wiśniewska – took up the problem of the influence of renal replacement therapy on the psychosocial state of dialysis patients. They found on the basis of the survey that the functioning of dialysis patients becomes significantly limited: 80% do not go on recreational trips, 72% do not participate in social life, and 50% give up their interests. The disease significantly influences the psychosocial sphere of dialysis patients.

Professor Janusz Wyzgał et al. describe transplantation methods of diabetes treatment. Diabetes is the most common metabolic disease in the world. It leads to dangerous complications in the form of microangiopathy and macroangiopathy. Patients with diabetic nephropathy treated with dialysis have significantly worse survival compared with patients without diabetes. An alternative to dialysis therapy is the simultaneous transplantation of kidney and pancreas, preferably before initiating dialysis. Another method is the transplantation of isolated pancreatic islets. However, the greatest hope is connected with genetic engineering methods in which hepatocytes, haematopoietic cells and embryonic stem cells are used to produce insulin.

Dr. Magdalena Wilczyńska-Borawska, Professor Jolanta Małyszko and Dr. Wanda Stokowska discuss the picture of lesions and dysfunctions within the oral cavity characteristic for patients with chronic renal disease in different stages of the disease and in dialysis patients. The authors' study shows that 70% of dialysis patients do not have the chewing function due to premature loss of teeth. Also a connection was demonstrated between the bad state of teeth and diseases of the circulatory system in the studied group of dialysis patients.

Dr. Edyta Zbroch, Dr. Dominika Maciorkowska, Professor Jolanta Małyszko and Professor Michał Myśliwiec present, based on their own material of patients undergoing peritoneal dialysis, the monitoring and control of blood pressure in this group of patients. In as many as 56% of patients unsatisfactory control of blood pressure was found. According to the authors, too few patients are treated in clinical practice with converting enzyme inhibitors.

Also two papers are presented concerning clinical cases: one of a female patient poisoned with Digitalis purpurea and treated with plasmapheresis; and two cases of kidney recipients with post-transplantation haemolytic-uraemic syndrome in the course of treatment with sirolimus.

Prof. dr hab. med. Magdalena Durlik