In memoriam: Professor Franciszek Kokot

Professor Franciszek Kokot: a true pioneer in nephrology

Professor Franciszek Kokot (Figure 1) was born on November 24, 1929, in Olesno Śląskie, Poland. He started his medical education in 1948 in the first class of a newly created Medical Academy in Rokitnica Bytomska (currently known as Medical University of Silesia in Katowice, Poland) and completed his medical education with distinction in 1953. Already at that time, Prof. Kokot was employed by his home Medical Academy as a laboratory technician at the Department of General Chemistry and later at the Department of Pharmacology, where he was also appointed after completion of his medical education. At that time, according to the existing rules, Prof. Kokot was forced to start his residency in the field of internal medicine as a volunteer at the 3rd Department of Internal Medicine of the Silesian Academy of Medicine, headed by the famous Polish internist Prof. Kornel Gibiński. This was the real beginning of Prof. Kokot’s future great scientific and clinical career. Already in 1958, he was appointed assistant professor at that department (in 1957, he defended his PhD thesis entitled “Kidney function during the artificial hibernation”) and in 1963, associate professor (after habilitation in 1962, based on his scientific achievements and the dissertation entitled “Studies on the mechanism of action of mercury diuretics.” In 1968, Prof. Kokot received the title of an associate professor, and in 1982, full professor of medicine awarded by the State Council of Poland.

Besides his successful scientific career, Prof. Kokot was also recognized as an exceptional clinician, who was a specialist in internal medicine, nephrology, hypertensiology, endocrinology, and clinical pathophysiology. With his good theoretical background in biochemistry, pharmacology, and pathophysiology, under the supervision of Prof. Kornel Gibiński, Prof. Kokot’s interest in water-electrolyte and acid-base disorders as well as in metabolic abnormalities in patients with acute or chronic kidney insufficiency developed. In 1965, Prof. Kokot became head of the Division of Nephrology at the Department of Internal Medicine, Silesian Medical Academy (currently Medical University of Silesia in Katowice), and in 1975, head of the Department of Nephrology, which he created almost from the scratch. In 1997, this department changed its name into the Department of Nephrology, Endocrinology and Metabolic Disorders, and finally in 2015, was renamed as the Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice. Prof. Kokot retired in 2000; however, he continued his scientific and clinical activity in his home department until 2016. It is also important to mention that in the 1960’s, Prof. Kokot created in Katowice one of the first dialysis units in Poland, and moreover, in 1993, the first dialysis unit for patients with end-stage chronic kidney disease treated in the Beskid spa hospital in Wysowa.

Prof. Kokot’s outstanding scientific and clinical achievements are also related to his role as an educator. He had amazing results as a teacher and supervised the specialty program in internal medicine or nephrology of around 100 physicians. He also supervised 79 PhD theses and 24 habilitations (additional 6 were conducted abroad in Halle, Rostock, Jena, and Berlin), from which 14 achieved the title of full professor in medicine. These impressive numbers may clearly indicate that Prof. Kokot created his own school of nephrology and his pupils became leaders and heads of several divisions or departments of nephrology not only in Poland but also abroad. This was his contribution to the fundaments of nephrology which separated from internal medicine in the 1960’s. Therefore, it is not surprising that Prof. Kokot was one of the founders of the Polish Society of Nephrology in 1983, and during the 49th Congress of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) in 2012 in Paris, he was named a Pioneer in Nephrology among other most eminent nephrologists from Europe. Prof. Kokot was the author or coauthor of more than 720 papers listed in PubMed, which in a large proportion were published in the high-impact international medical journals. The entire number of published medical articles by Prof. Kokot exceeds 1400, among them, more than 820 published as full-text articles.

Most famous scientific topics which brought him international recognition are related to endocrine abnormalities in patients with acute or chronic kidney insufficiency, in patients with primary or secondary hypertension, after kidney transplantation and also in patients with kidney stones. The second most important area of scientific interest expressed by Prof. Kokot was to demonstrate that kidneys play an important role as an endocrine organ, which can be used both for diagnostic procedures as well as in the pathophysiological considerations in patients with hypertension or kidney diseases. Prof. Kokot in his unique way was able to utilize his knowledge which he acquired during his long-term (Geneva, 1959–1960) or short-term (London, 1970) scholarships and to build his own scientific laboratory, where based on his own radioimmunological methods, he was able to assay several hormones. At that time, measurements on such a large scale (not only in Poland but also in all other communist countries) were performed only using these own methods which Prof. Kokot elaborated in his laboratory. It is also important to mention that most valuable and innovative results published by Prof. Kokot were related to the role of the renin–angiotensin–aldosterone system in the pathogenesis of arterial hypertension and in kidney diseases. He published more than 200 papers in this particular field in several prestigious medical journals both in Poland and abroad.

Besides these original, scientific works, Prof. Kokot has been also an editor of several important textbooks for students and physicians. The most important book, which had several editions and was recognized as a most valuable academic textbook, was entitled Internal Diseases. Additionally, Prof. Kokot was an editor of several other books, which were also important and unique with regards to both their content and the form of presentation, such as, Water-electrolyte and acid-base metabolism in physiological and pathological conditions and also Differential diagnosis of disease symptoms. Finally, it is important to stress that Prof. Kokot also translated many books from German or English into Polish, among them a most famous textbook, Harper’s Biochemistry.

Prof. Kokot played an important role in many national and international scientific societies. From 1989, he was elected 3 times as the president of the Polish Society of Nephrology. During his presidency, Polish nephrology was introduced into the international community. Prof. Kokot was also elected 3 times as a council member of the ERA-EDTA in the years: 1978 to 1981, 1987 to 1990, and 1993 to 1996. As an ERA-EDTA council member, Prof. Kokot organized a memorable meeting in the Vatican with Pope John Paul II, which was concluded with a very important statement supporting the idea of organ donation for transplantation. This initiative is considered to be a fundamental stage in the development of organ donation and transplantation. Prof. Kokot was also a council member of the International Society of Internal Medicine, Polish Society of Internal Medicine, and Polish Society of Hypertension. He was involved in the development of science and higher education in Poland, namely, he was elected vice-rector (since 1980) and then rector (1982–1984) of Silesian Medical Academy, was a member of the State Committee for Scientific Research (Komitet Badań Naukowych) and also a member of the Central Commission for Degrees and Titles (chairman of the Medical Section in 1978–1990 and 1993–2006). Prof. Kokot was a full member of the Polish Academy of Sciences (Polska Akademia Nauk) and an active member of the Polish Academy of Arts and Sciences (Polska Akademia Umiejętności). He was also awarded the honorary degree (doctor honoris causa) of 10 Medical Universities in Poland and abroad (including Jagiellonian University in Kraków). Additionally, he was a honorary member of several scientific associations in Poland and abroad. It is important to mention that Prof. Kokot was the recipient of a very unique and prestigious honorary membership of the ERA-EDTA in 2010. For his outstanding achievements in the field of education and science, he was awarded with the highest distinctions in Poland, namely, the Knight’s Cross and Commander’s Cross of the Order of Polonia Restituta. Posthumously, Prof. Kokot received the Order of the White Eagle.

Prof. Kokot passed away on January 24, 2021. It is very difficult to present in such a short way all his achievements and merits. It is even more difficult to present him as a charismatic speaker, visionary in many scientific areas, organizer of the nephrological care in Poland, and extraordinary physician, who in spite of so many different activities, was involved also in patient care on a daily basis. However, to present Prof. Kokot as our teacher and mentor is most difficult for us because this influence was so vast that it covered our entire professional and scientific lives.