[What type of neprologist for the beginning of the third millennium?]

During the last 10-15 years the International, but especially, the American Nephrology have been more and more colonized by the basic sciences. This has led to advocate for the future a nephrologist oriented towards the basic sciences. While nobody would deny that the basic sciences will be useful for the development of nephrolologic knowledge in the next decades, there are very urgent clinical problems in the present that should alert against this attitude. The most actual problem is represented by the new kind of patients affected by renal diseases who are older and much more complicated than in the past. Furthermore, todays patients need to interact with the clinician and require to be informed about the diagnostic and therapeutic procedures proposed. Although it is obvious that a deep knowledge in the basic sciences may be useful in improving the clinical care, the existing situation makes it impossible to propose a nephrologist being able at the same time to take care of all clinical and relational problems of patients with renal diseases and also to be well oriented in the basic sciences. This imposes a choice: If the aim of nephrologist involved in the clinical care is directed to the development of nephrologic knowledge to be applied in the next decades, then it may be reasonable to have more and more people oriented towards the basic sciences. On the contrary, if the aim of nephrologist is directed to offer the best available care to the patients, then there is no choice: no chance for a basic sciences oriented nephrologist.