by Lorraine Bell

Two people played pivotal roles in the establishment of the Canadian Association of Pediatric Nephrologists (CAPN): Peter McLaine spearheaded the formation of the pediatric section of the Canadian Society of Nephrology (CSN/SCN). After three years of discussions and meetings, it was officially established in 1983. A decade later, Brian Steele, while president of the pediatric section of the CSN/SCN, organized the creation of an independent society, the Canadian Association of Pediatric Nephrologists, affiliated with the CSN/SCN. The two organizations formalized their links in 1998 with the inauguration of a combined membership. The CAPN is represented on a number of committees of the CSN/SCN, including the education committee, the professional and public policy committee, and the CSN/SCN Council.

There has been continued enthusiasm, with scientific meetings every year in conjunction with the Canadian Society of Nephrology and the Royal College. March 2000 marked the first standalone CSN/SCN and CAPN joint conference; from all reports, it was a resounding success! There was pediatric content in every scientific session or symposium and attendance was at a record high. The personal recollections of the two founders of the CAPN illustrate the tremendous effort involved.

The pediatric section of the CSN/SCN: A brief history

by Peter McLaine

During the summer of 1980, l wrote to all Canadian pediatric nephrologists to ask if they supported the idea of a separate meeting during the International Society of Pediatric Nephrology meetings in Philadelphia in October 1980. The response was extremely positive and we held a meeting on October 7, 1980. Attendees included Gerald Arbus, Michael Brown, Jim Carter, Keith Drummond, Frances Harley, Richard Hung, Bernard Kaplan, Peter McLaine, Jean-Guy Mongeau and Sean O'Regan. Bill Balfe, David Churchill, John Crocker and Bob Walker were unable to attend the meeting but sent their support.

The consensus was that there should be an organization of pediatric nephrologists in Canada, which at that time numbered 23. The group felt there were many areas in which pediatric nephrologists as a group could have greater input, such as compiling statistics, involvement with various national societies and engagement in collaborative studies. There was much discussion regarding the implication of forming a Pediatric Nephrology Society separate from the Canadian Society of Nephrology. Peter had discussions the CSN/SCN president Cal Stiller, who indicated a need for more pediatric input into the CSN/SCN, especially regarding content of the scientific programs. At the 14th Annual CSN/SCN Council Meeting (September, 1981), Peter made a submission regarding the organization of a pediatric section of the Canadian Society of Nephrology and the Council agreed in principle.

On September 16, 1981, a half-day pediatric nephrology meeting was held at the Hospital for Sick Children combining a scientific and business session. Fifteen pediatric nephrologists attended, as did one invited guest, John Patrick, MD, a nutritionist from the school of medicine at the University of Ottawa. The scientific program was devoted to chronic renal failure in children; the speakers included Bill Balfe, Jim Carter, Sean O’Regan and John Patrick.

At the business meeting that followed, those assembled agreed that a working group (Bill Balfe, Peter McLaine, chair, and Jean-Guy Mongeau) would continue as an executive. Their mandate was to establish the pediatric section of the CSN/SCN and to organize a symposium for the 1982 annual CSN/SCN meeting in Quebec City.

During the following year, Dr. Mongeau, the new president of the CSN/SCN and, Drs. Balfe and McLaine met to work out details of by—law changes required to establish the pediatric section. They also organized a symposium on “Hereditary Renal Diseases” for the Quebec City meeting. It included guest speakers Martin Barratt (London, England), John Crocker, Andre Gougous, and Charles Scriver.

A year later, in September 1983, the pediatric section of the CSN/SCN was officially ratified at the annual CSN/SCN meeting in Calgary.

On January 20, 1984, the executive of the pediatric section and CSN/SCN president, David Levine, met in Ottawa. Dr. Levine indicated that the president of the pediatric section would be a member of CSN/SCN Council and 3 representatives on the scientific program committee, for abstract review. As for the structure of the executive of the pediatric section, it was proposed that there be three officers: president, first vice-president, and second vice-president. It was agreed that the president retain office for two years; the first vice-president then move up to the position of president and the second vice-president become first vice-president. The second vice-president would also act as secretary and Peter McLaine was to continue as president until the next meeting in September 1984. Thereafter, the past president would become the nominating committee and nominations would take into consideration geographical distribution of the country. The group felt that elections should be held by mail since there were very few pediatric nephrologists at the 1983 Calgary meeting. Following this, all pediatric nephrologists in Canada were contacted; 22 of the 29 responded and unanimously endorsed the above proposals.

The establishment of the Canadian Association of Pediatric Nephrologists

(Excerpts from a letter from Brian Steele)

DEAR LORRAINE,

Thanks for asking about the formation of the Canadian Association of Pediatric Nephrologists. When I was president of that section in 1993, I sent all members a letter (March 4, I993) asking their views of the formation of an independent association. There was overwhelming support (I still have the replies and you said yes!). Jean-Guy Mongeau corrected my French and the bilingual association was patented on April 14, 1994.

We had our first meeting in September of 1994, linked to the CSN/SCN meeting. There was a joint symposium on genetic renal disease and pediatric pathology and fluid and electrolyte cases. There were joint symposia for at least two years after 1994.

During the September, 1994 symposium, we organized a dinner at the Byzantium Restaurant in Toronto to celebrate the start of the Canadian Association of Pediatric Nephrologists. There, we honoured the four pioneers of pediatric nephrology in Canada: Drs. Keith Drummond, Phil Rance, David Lirenman and J.G. Mongeau. The latter two were unable to attend, but the highlight of the evening was Keith Drummond’s speech, where among other things, he claimed that his contributions to nephrology were minimal.

Instead, he claimed that his greatest achievement in life was the construction of a log cabin somewhere outside of Montreal! Another item that might be of interest to history is the Children’s Dialysis Camp. The first camp in Canada took place in the summer of 1979 in the Okanagan Valley. After two years, the camp moved to Muskoka, Ontario and has remained there ever since. For many years, it attracted children with kidney failure From almost every province. The facilities were always able to do haemodialysis, peritoneal dialysis and look after those with transplants.

Yours sincerely,

Brian T. Steele

The Canadian Association of Pediatric Nephrologists: A commitment to research

Over a decade ago, Peter McLaine set up the Canadian Pediatric Kidney Disease Research Centre, laying a firm foundation for collaborative pediatric nephrology investigation in Canada. Important studies have included work on the epidemiology and treatment of haemolytic uraemia syndrome (HUS).

During the past year, there have been several new and exciting developments. October I999 saw the first of a series of extremely animated Canada-wide pediatric nephrology research gatherings, organized as satellite symposia at the ASN meeting in Miami and then at the CSN/SCN annual meeting in Montreal. A CAPN research consortium is being established, with major meetings planned for twice a year. Several multicentre studies are about to be launched; energy and enthusiasm are running high!

We’ve traveled a great distance in pediatric nephrology since 1964. What will the future bring? It's difficult to imagine the changes that will unfold in the next 36 years. Gene therapy and xenotransplantation are already on the horizon. What will our children and grandchildren say about the way we practice now?

Executive of the Pediatric Section of the CSN/SCN and the Canadian Association of Pediatric Nephrologists

Working group for establishment of the Pediatric Section of the CSN/SCN, 1980-83

Peter McLaine (Chair), Bill Balfe, Jean-Guy Mongeau

President of the Pediatric Section of the CSN/SCN

1983-84 Peter McLaine

1988-86 Bill Balfe

1986-88 Frances Harley

1988-90 Jean Guy Mongeau

1990-92 john Crocker

1992-93 Brian Steele

The Canadian Association of Pediatric Nephrologists

President

Sept 1993-Sept 1994 Brian Steele

Sept I994-Sept 1996 Paul Goodyer

Sept 1996-Sept 1998 Morrison Hurley

Sept 1998-March 2001 Lorraine Bell

March 2001-March 2003 Denis Geary

Secretary-Treasurer

Sept 1993-97 Gerald Arbus

Sept 1997- Julian Midgley