The National Kidney and Urologic Diseases Advisory Board report.

I Is fitting that the inaugural issue of the Journal ofthe American Society ofNephrology highlights the 1990 Long Range Plan of the National Kidney and Urologic Diseases Advisory Board. The release of this historic report in March 1 990 signalled the beginning of a critical period for the future of nephrology. Achievement of the major recommendations outlined In this long-range plan would substantially improve the health of our patients and reduce the burden of renal and urologic disease on the nation and the world. Heretofore it has been difficult to provide a comprehensive summary of the extent of renal and urologic diseases and their impact on American society. The absence of data and the failure to enunciate objectives for future strategies have precluded the development of a coordinated and comprehensive plan to squarely address these problems. To correct this situation, Congress authorized the establishment of the National Kidney and Urologic Diseases Advisory Board; and in 1987. the Board began its congressionally mandated task of developing the first national ten-year plan to combat kidney and urologic disease. The American Society of Nephrology was very well represented on the Board, and the Board’s Chairman, Dr. Stuart A. Kleit, adroitly combined leadership, patience, and determination to coordinate the Board’s activities and hearings. This major effort included gathering testimony from nearly 1 ,000 individuals representing patients, health professionals, researchers, and members of relevant voluntary and professional organizations. The report contains an extraordinary analysis of the challenges facing us and clearly enunciates achievable goals and objectives to prevent renal disease and to improve the diagnosis and therapy of nephrologic and urologic conditions. The problems are immense! Kidney and urologic diseases affect over 13 million Americans with minorities suffering disproportionately. In 1987, over a quarter million people died from kidney and urologic diseases, and 8% of the total of all health-care costs in the United States, about $50 billion, was spent on the management of kidney and related diseases. Although 8% of health expenditures are attributed to renal and urologic diseases. only 2.5% of the NIH research budget is spent for renal and urologic research. In 1989, the Health Care Financing Administration spent $3 billion for the treatment of end stage renal disease. In addition, millions of dollars are spent by private insurers and individual patients. The indirect costs of these diseases, although precisely incalculable. are estimated to be in the billions. The Council of The American Society of Nephrology. speaking for its members, wholeheartedly supports all of the recommendations in the long-range planning document. Furthermore, we believe that major emphasis should be placed on fundamental and clinical research to prevent or effectively treat these conditions. prior to the development of end stage renal disease. Hence, the ASN places primary emphasis on the following recommendations of the report: