[Studies on the kidney and the renal circulation, by Josep Trueta i Raspall (1897-1977)].
BACKGROUND
Josep Trueta i Raspall, born in Barcelona in 1897, was one of the most outstanding european surgeons of his time. In 1936, after the military coup and during the subsequent Spanish civil war, he was in charge of the Surgery Service at the Hospital de la Santa Creu y Sant Pau and begins to performe a closed method to treat open fractures of the limbs, dramatically lowering the number of gangrenes and amputations between troops and civilians. At the end of the war came the exile, and he was invited by the british Health Service, he teach in Oxford and applies his knowledge on war surgery, was named PhD (Hon) and professor of ortopedics, and creates an school of clinical investigation that generates important findings in bone growing and pathology and, amont other areas, in the knowledge of renal function and kidney injuries induced by shock and blood hypertension. One of the most outstanding fruits of this investigation is the book "Studies on renal circulation", first published in English in 1947 (Oxford), then in Spanish in 1949 (Barcelona).


METHODS
Study of Josep Trueta's biography and works on kidney function, especially the book "Studies on the renal circulation", relating them to the state-of- the- art of nephrologic studies of his time.


RESULTS
Trueta and his group were pioneers in the study of the causes of postraumatic oliguria in war wounds. On the basis of the first studies on crush syndrome, published in 1941, were the kidney failure that followed the extended injuries of the limbs was pointed out, they could demonstrated the changes in renal circulation that followed different injuries to the limbs, such as ischemia, haemorrhage and infections. "Studies on the renal circulation" and other papers published in journals of high scientific impact, shown the renal cortical ischemia with preservation or increase of the medullar and yuxtamedullar circulation that takes place in those pathological situations (Trueta shunt). Although their contributions and hypothesis were not definitives, they served as the basis to studies performed later on, on acute kidney failure secondary to shock, glomerulonephritis, transplant rejection and blood hypertension.


CONCLUSIONS
Trueta's works are unusual examples of investigations directed to answer clinical questions. What may calls one's attention is the wide field of investigation he moves on, that today would involved several medical specialities, different to his task as orthopedic surgeon. On the other hand, his love by Catalonia, his country, moves him to write "The spirit of Catalonia" (1946), a short text for English-speaking people, on the political and scientific history of Catalonia. Trueta was in the end, an humanistic intellectual with broad interests, reflected on his books on travels or on the life of classic sages such as Luis Vives, Miguel Servet or Cajal. He returned back to Catalonia in 1966 and died in 1977. His book "Studies on the renal circulation", exquisitely illustrated and edited deserves a distinguished place in the European medical and urological historiography.
Servicio de Urología, Hospital Povisa, Vigo, Pontevedra. luisfarina@yahoo.com
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D049673:History, 20th Century; D007668:Kidney; D012079:Renal Circulation; D013030:Spain; D014572:Urology / Q000266:history