Carl Magnus F. T:son Kjellstrand, MD,
PhD, was this year’s recipient of
the Annual Award for Lifetime
Achievements in Hemodialysis. Born in
Svenljunga, Sweden in 1936, he studied at
the University of Lund Medical School in
Lund, Sweden, and received a Bachelor
of Science degree in 1956, and MD degree
in 1962.
As a medical student, Carl worked
first in the capacity of Research Assistant
in the Department of Histology, then as a
Research Assistant in the Department of
Nephrology. His first academic appoint-ments
were at the University of
Minnesota, starting as a Research Fellow
in 1963 and progressing to full Professor
from 1974 to 1990. In 1988, he served as a
Docent in Internal Medicine at the
Karolinska Institute in Stockholm, Sweden.
From 1990 to 1997, Dr. Kjellstrand
held several Academic Appointments in
Medicine, Bioethics, and Epidemiology at
the University of Alberta, Canada, at Wake
Forrest University, Winston Salem, and at
the University of Washington, Seattle. He
currently holds Academic Appointments
in Medicine at the University of Alberta,
State University of New York in Brooklyn,
and Loyola University in Chicago.
Carl has always been an outstanding
teacher. He has received many awards for
teaching excellence, starting with recognition
of his division as the best Division in
the University of Minnesota in 1977 and
1978. He was also acknowledged as Best
Teacher in 1978. ASAIO honored him for
the best paper, “Zirconium Phosphate,”
in 1981. The Central Society for Clinical
Research awarded him the E. Lilly Prize
for presentation in 1986. Finally, Carl
was regarded the Superior Teacher in the
University of Alberta in 1992, and the
First Opponent by the University of Lund
in 1995.
Carl’s bibliography is impressive and
tallies almost 500 articles, half in peer-reviewed
journals. In addition to articles,
he has submitted more than 300 abstracts,
of which more than 200 have been select-ed
for presentations. Carl is a member of
31 professional societies, and has served
40 times as an officer, including President
of three societies. He has edited 16
Symposia, has served on editorial boards
of 30 journals, has reviewed manuscripts
for 34 journals, and has served on 54 various
committees.
Why did Carl choose dialysis nephrology
for his career? He could have excelled
in any field of medicine. Everything start-ed
in his “lucky year 1957.” Carl met To
Kerstin E.M. Clifford, his wife to be. Her
parents were neighbors of Professor Nils
Alwall, so they met socially. Professor
Alwall created and became head of the
Department of Nephrology, Carl’s first
clinical rotation. The first, very ill, septic
patient with acute renal failure recovered
after 2 weeks of hemodialysis. Carl was so
impressed that he wrote an obligatory
medical case report and accepted a
research assistant position.
Shortly thereafter, Carl was exposed
to dialysis in chronic renal failure. A young
man was admitted for dialysis in Lund
with uremia from rapidly progressive
glomerulonephritis. He was an old high
school friend of Carl’s. He was kept alive
on the artificial kidney for 180 days, the
longest case ever at that time. Three years
later, Carl was in Seattle training in clinical
dialysis and met Robin Eady, a young
physician from London with the same
disease. Robin is alive today after some
25 years of dialysis and 10 years of transplantation.
The results with chronic
dialysis were so spectacular that Carl was
completely sold on dialysis nephrology.
Dr. Kjellstrand’s research encompasses
vast areas of nephrology, but the most
important was the creation of the concept
of dialysis “unphysiology” in the 1970s. At
that time, in most dialysis centers, including
that at the University of Minnesota,
dialysis frequency was established at two
or three times per week. High perfor-mance
dialyzers had been developed and
it became fashionable to shorten dialysis
duration and increase efficiency. Dr.
Kjellstrand was one of the first to notice
side effects of short, efficient dialysis.
Several Kjellstrand papers published in
the middle 1970s addressed this problem
and introduced the concept of dialysis
“unphysiology.”
The trend of short, efficient dialysis
continued, particularly in the United
States, into the 1980s. At the same time, it
was noted that mortality and morbidity
was high in US patients. After a thorough
review of dialysis practices over the world,
Dr. Kjellstrand concluded that the reason
for high morbidity and mortality is short
dialysis duration.
In the late 1980s, Dr. Kjellstrand
moved to Stockholm, to take the position
of Chief of the Division of Nephrology at
the Karolinska Hospital. At the same time,
his interest widened to include ethical
problems related to dialysis programs. He
wrote a thesis, “Ethical Problems of High
Technology Medicine,” and received a
PhD degree from Karolinska Institute,
Stockholm, in 1988. Bioethical problems
continued to be his main interest from
1990 to 1997, when he served as a staff
physician in the division of Nephrology
and Bioethics in the Department of
Medicine at the University Hospital in
Edmonton, Alberta.
Because of his conviction that the
best hemodialysis is frequent hemodialy-sis,
Dr. Kjellstrand accepted the position
of Vice President Medical Affairs, AKSYS,
Ltd, Lincolnshire, Illinois, in 1997. The
company is developing a machine for
daily hemodialysis.
The multiple honors granted to Dr.
Kjellstrand illustrate the esteem he enjoys
in the nephrology community throughout
the world. To mention only a few, he is an
honorary member of the Peruvian Society
of Pediatrics, Peruvian Society of
Nephrology, and the Venezuelan Society
of Nephrology. He has been an
International Scholar in the International
Information Institute in Tokyo, Japan, a
Silver Medalist of the Bologna University
900 year jubilee for Scientific
Achievements, and a Research Professor
to Egypt selected by the International
Society of Nephrology. 
