Draft:European Society for Paediatric Nephrology

The European Society for Paediatric Nephrology promotes the circulation of research and clinical knowledge through scientific meetings, teaching, and research grants to improve the treatment of children with kidney diseases in Europe.

The medical discipline of pediatric nephrology is a sub-discipline of pediatrics. It studies kidney development, physiology, pathology, as well as diseases of kidneys and urinary tract. Pediatric nephrologists mostly work in university hospitals or hospitals of tertiary medicine providing full scale treatment options for children with diseases of kidneys or urinary tract.

History
Pediatrics only became a specialist medical discipline in the late 19th century. However, it was not until 1910 that the International Paediatric Association (IPA) was founded, and the first International Paediatric Congress organised in 1912.

Nephrology itself was even slower to develop. It was only after World War II that a few teams of internists concerned with renal care in adults began organizing on both sides of the Atlantic. In the 1960s, the clinical management of patients with renal diseases, both adults and children, was still handled mostly by general physicians. Yet by the 1970s pediatric nephrology had started to emerge as a distinct subspeciality.

Founded in 1967 with Gavin Arneil as the first Secretary General, the European Society for Paediatric Nephrology preceded its US counterpart, the American Society of Pediatric Nephrology, by two years. It proved a milestone for the discipline’s worldwide development. The first ESPN meeting in Glasgow of September 1967 would be followed by annual meetings, usually hosted in summer or autumn by one of the ESPN members.

At the end of the 1971 meeting in Paris, pediatric nephrologists from every continent formed a worldwide organization representing global pediatric nephrology with Ira Greifer, MD as the first Secretary General. It led to the foundation of the International Pediatric Nephrology Association (IPNA).

Organization
Today, more than 2000 pediatricians from 46 European countries work in the field of pediatric nephrology. About 700 of them are ESPN members and about 900 attend the annual ESPN meetings during the so-called Paediatric Kidney Week.

The organization is built around a Constitution, drafted by a Council, and centered around three principles:
 * 1) ESPN was to be a single-language society to ensure free communication, discussion, and easy exchange of scientific data. English was chosen as lingua franca.
 * 2) The society was to be restricted to specialist membership to permit ordered growth and development.
 * 3) All Western and Eastern European countries were to be included, as well as Turkey and Israel, in an effort to avoid ‘elitist’ concentrations of knowledge.

At the time of ESPN’s foundation, the society’s main objectives were the organization of high-quality scientific events and the stimulation of collaborations between its members. These objectives have largely been maintained to this day, even if the spectrum of members did expand from specifically-trained pediatric nephrologists to include general pediatricians with a specialist interest in nephrology.

Harmonization
In 1998, a survey conducted by the ESPN revealed substantial disparities in pediatric renal care among European countries. It was therefore decided that the society would aim to harmonize renal care in all European countries over the next 20 years. In 2017, a follow-up study was conducted to evaluate the then current state of rental health policies for children in Europe. It revealed that over these two decades, pediatric nephrology had become a well-established subspecialty of pediatrics and nephrology. Accordingly, ESPN decided to continue its harmonization efforts of remaining disparities by intensifying cooperation between national pediatric nephrology societies, and so further improve pediatric renal care for European children through training/education and cross-border collaboration.

Training & Board Examination
In 2014 IPNA and ESPN together launched the Junior Master Class program in keeping with ESPN’s ambition of harmonizing the pediatric nephrology activities and education in Europe. It was especially designed for fellows in pediatric nephrology, young pediatric nephrologists, residents in pediatrics, and pediatricians with special interest in pediatric nephrology.

Following the pediatric nephrology syllabus, approved by the ESPN council and the European Academy of Pediatrics in 2019, the IPNA-ESPN Junior Master Class program comprises the whole pediatric nephrology curriculum over a seven-day course and 50 lectures, distributed through annual educational sessions, to complete the curriculum in three years.

Every year, the IPNA-ESPN Junior Master Class program is evaluated by the European Accreditation Council for Continuing Medical Education (EACCME®) and the sessions are granted with a number of European CME credits (ECMEC®).

Since 2014, three courses (for a total of nine sessions) have been delivered, educating more than 1000 candidates from over 70 countries and five continents. Participants who complete the three-year course receive a Master’s diploma in pediatric nephrology recognized by both ESPN and IPNA.

As of 2019, ESPN organizes annual online Board Examinations for those who fulfill the eligibility criteria. Successful candidates received ESPN Board certification in Pediatric Nephrology.

Working Groups
There are several ESPN working groups focusing on specific areas of pediatric nephrology. Each group includes a convenor who runs the working group, and an individual who liaises with the ESPN Council. There are currently 6 ESPN working groups:
 * 1) Transplantation
 * 2) Dialysis
 * 3) CKD-MBD
 * 4) CAKUT/UTI/Bladder Dysfunction
 * 5) Glomerular Diseases
 * 6) Inherited Renal Disorders

Research & Grants
ESPN regularly awards a number of research grants. At the Spring 2020 ESPN Council meeting, the frequency of grant awards was increased from biennially to annually. The awards are open to ESPN members only. The society supports research via the following programs:
 * 1) General Awards
 * 2) ESPN Working Group Awards
 * 3) Start-up Grants
 * 4) ESPN/ERA Registry Travel Grants

Furthermore, ESPN and The Pediatric Nephrology Research Consortium (PNRC) have created a joint research program to provide funding and opportunity for researchers from each organization to conduct research on shared projects. The decision to create a joint research program was born out of a desire to promote greater partnership and collegiality between pediatric nephrologists in Europe and North America.

Guidelines
ESPN fosters the development of interdisciplinary guidelines in the field of pediatric nephrology. These are developed by teams of ESPN members but also include other specialties like pediatric urology, pediatric endocrinology, internal medicine, genetics, pathology, and patient representatives. The guidelines are distributed via webinars as well as presentations at the Pediatric Kidney Week, and are regularly updated.