[Nephrology in the first decade of the twenty-first century]

Although prophecy in medicine is extremely difficult, I do not expect, that xenotransplantation will become reality in the first decade of the 21th century. However I expect introduction of safer and more effective immunosuppressive agents or even induction of selective immunologic tolerance in kidney transplant patients. I expect a significant decline in the number of uraemic patients with diabetic or hypertensive nephropathies, thanks to better prevention and treatment of these pathological states. I predict intensification of studies of renal fibroblasts responsible for progression and loss of renal parenchyma in nephropathies of different etiology. Gene therapy will become a reality both in inborn and acquired nephropathies although safety of this kind of therapy remains to be established. Finally I expect essential improvement of therapy in clinical settings induced by abnormal homeostatic function of the kidneys mostly thanks to our better understanding of the molecular background of this function.