Originally published in Volume 36 Issue 3 of Artificial Organs, 06 March 2012
My career trajectory in nephrology started already during my medical studies when I learned that from more than 150 L of glomerular filtrate, only about less than 1% is finally excreted as urine. From these data, I concluded that humoral factors (and not only activity of the autonomous nervous system) must be involved in the reabsorption process of such a large volume of primary glomerular filtrate. My love for nephrology deepened during my work for 7 years as junior and senior assistant in the Department of Pharmacology where I studied the influence of artificial hibernation on renal glomerular filtration rate, renal blood flow, and diuresis. Results of this study became the basis of my doctorate thesis, which I defended in 1957. Parallel to my work in Pharmacology, I worked as a volunteer in the III Department of Internal Medicine headed at that time by a brilliant scientist Prof. Dr. K. Gibiński. In 1957, the Chief of the Department of Pharmacology was replaced by a new man with whom I could not find a common language. Sticking to the Polish proverb, “It is better to lose with a bright man, than to gain with a stupid one,” I divorced my beloved pharmacology and decided to work only at the Department of Internal Medicine. Very soon, I became head of the clinical laboratory, which I supervised up to the end of my active professional life (2000). Of course, I continued my studies on water–electrolyte disturbances in chronic cardiac failure especially examining the role of aldosterone in the pathogenesis of cardiac edema. In 1958–1959, I worked with Prof. R. Mach in Geneva (Clinique Therapeutique Universitaire) where I learned a lot about humoral factors regulating the exocrine function of the kidney. In 1970, I spent some months at Saint Mary’s Hospital with Prof. Peart, and at Middlesex Hospital with Prof. O’Riordan. In 1976 and 1986, I was a visiting professor in the USA lecturing at 20 universities.
In the early 1960s, it became evident that the kidney is not only an exocrine organ but also an important endocrine one. It is the target for different hormones involved in the regulation of blood pressure, and of different biochemical pathways involved in the maintenance of the human homeostasis (in the broad sense of this term). In order to get instruments for studying the endocrine function of the kidneys in different pathological states and the relationship between renal function and function of classical endocrine organs, it became mandatory to develop contemporary methods for the estimation of different hormones in nanomole or even femtomole concentrations. For this purpose, we produced antibodies for the assessment of more than 15 hormones and elaborated appropriate radioimmunoassays, which were used not only for scientific but also diagnostic purposes. This way, we became independent from the import of very expensive kits from Western European countries and could essentially broaden our scientific activity. As I was nominated Director of the Department of Nephrology in 1974, all my laboratory capacity was used for solving nephro-endocrinological problems (functioning of the endocrine system in acute and chronic renal failure, active renal stone disease and arterial hypertension, erythropoietin secretion, etc.).
I have to stress that before the fall of the Berlin Wall, it was very difficult to be a productive clinical investigator, and the question arose as to how I could manage to build a solid research group and remain in close contact with Western colleagues. The answer could be the following.
After mastering the methodology of antibody production for assessment of different hormones and elaboration of my own radioimmunoassays, the only difficulty was to find funds for the purchase of α-, γ-, and β-counters. This difficulty was overcome by my boss, who was a well-recognized and highly regarded scientist not only in Poland and found connections to get the necessary funds.
Being the head of a modern laboratory and working with dedicated collaborators, it was possible to be in good competition even with Western nephrology. By presenting our studies at different international congresses, I forged friendship with nephrologists all over the world who opened their laboratories to my colleagues, while over 20 fellows from Eastern European countries were trained in my department. Fifteen of my collaborators were trained in the USA (4) or Western European countries (11) for 1–2 years. The contributions of these colleagues were essential to our scientific potential. In addition, I was elected as a council member of the European Renal Association–European Dialysis and Transplantation Association (ERA-EDTA) for 9 years (in total), which allowed me to have close contacts with first-line nephrologists from all over the world.
The flywheel of my scientific inspiration was my first boss, Prof. K. Gibiński, who, more than 50 years ago, prophesied the face of medicine in the year 2000. My contribution to nephrology was that I met (or rather selected) dedicated and loyal collaborators who were bright, hardworking, and willing to realize my scientific projects. The mottos I followed scrupulously during all my life were, “Not to demand from my collaborators more than from myself” and “To accept successes of my fellow-nephrologists with humbleness and dignity.”
Don’t think that I am conceited saying that only by working hard in concert with intelligent and dedicated collaborators was it possible to create a harmoniously performing orchestra. This orchestra comprised 77 doctors. By dividing my published scientific output by 76, I should rather be ashamed to have done so little.
In the last 50 years, my beloved nephrology was the flywheel of medical progress and I am convinced that it will continue this role in the coming years.
The career of Professor F. Kokot started already during his medical studies (1948–1953). He defended his doctoral thesis in 1957. By elaborating radioimmunoassays for 15 different hormones, he studied the function of endocrine organs in patients with acute or chronic renal failure, arterial hypertension, and renal stone disease. He was awarded with the honorary membership of 13 scientific societies, and with the Doctor Honoris Causa at nine universities. He is an honorary member of the ERA-EDTA, and a Fellow of the Royal College of Physicians (Edinburgh). He was a member of the ERA-EDTA for 9 years and of the International Society of Nephrology nominating committee for some years. He also mentored 51 licensed nephrologists.