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The new NDT series Ideas, Conjectures and Refutations (ICR):
elegance in nephrology research
modern support to this principle. Popper argued that we select
simpler theories "because their empirical content is greater;
and because they are better testable". Admittedly, as emphasized by Nathan and Brancaccio, “elegance” in science overlaps, but does not coincide with simplicity. Also beyond
humanities, an element of aesthetics and beauty is considered
inherent to “elegance”. Therefore this concept has less defined
borders than simplicity. Yet the vast majority of scientists
would agree on the fact that the quest for simplicity is at the
heart of fascinating good science. All nice examples collected
by the authors as paradigms of scientific elegance in nephrology, from the trade-off hypothesis to glomerular hypertension,
are in essence “chef-d’oeuvres” of ingenious simplification and
simplicity. In closing their intriguing paper, Nathan and Brancaccio mention the risk that modern clinical science may
become a cold territory based only on methodological rigour
and mathematical analysis and allude to the fact that metaanalytical methods do not convey a sense of creativity, a relevant element in the concept of elegance, and fall short of
being elegant. I agree that creativity, now increasingly often in
the form of well-construed thought-synergism rather than of
individual genius, remains central to science advancement and
elegant theory generation. Yet the propensity by these authors
to privilege the aesthetic and the “individual creativity” components of elegance over the numerical one, is debatable and
I disagree with this view. A well-thought out meta-analysis
may have the fragrance of a distillate. I am sure that Diego
Brancaccio, also an expert enologist, would not deny the attribute of elegance to a high-class Bordeaux blending several
grapes. In the same vein, I would not deny the same attribute
to an intelligently crafted meta-analysis distilling and melting
the most valuable information produced across several studies
on the same issue. In closing, with the presentation of this first
IHR paper, I also take the opportunity to announce that in the
second half of the year we will start a new educational series
on meta-analysis. I am confident that this novel series will be
an elegant effort to help the growth of knowledge on the application of systematic numerical reviews for the distillation of
clinical knowledge to be applied in every-day practice in nephrology.
Carmine Zoccali
Editor in Chief
In this issue of NDT, we inaugurate the new series of papers
Ideas, Conjectures and Refutations (ICR). This new feature of
our journal is sister to Polar Views in Nephrology and aims at
creating a special space to host novel scientific ideas, amenable
to empirical falsification and well-reasoned proposals for dismissing old hypotheses and theories on the basis of new scientific evidence. The title intentionally echoes the Popperian
philosophical masterpiece “Conjectures and Refutations”. Even
though new theories of scientific knowledge have been produced, science in biology and in medicine remains largely
Popperian, and the principle of falsification profoundly informs
basic and clinical research and remains central for adjudicating
the “provisional truth” of scientific theories. In launching this
new series, I am very pleased that Professor Eberhard Ritz, an
Editor Emeritus of NDT who did so much to establish the reputation of our Journal, has accepted to lead the series. He has
already produced a list of very stimulating issues to dissect in
this new feature of NDT, and I am confident that our readership
will enjoy Ideas, Conjectures and Refutations papers.
The inaugural paper of ICR is an essay by Marco Nathan, a
young philosopher at Denver University, and Diego Brancaccio,
a well-known clinical investigator and science manager, focusing on elegance in science. In introducing their reasoning, these
authors say that “we fall short of rigorous definitions of elegance
per se and of elegant science” and tactfully adopt a nice, minimalist approach to the issue. They make an attempt at examining
the importance of “perceived” elegance in modern science by
making examples taken within the nephrology realm. They
equate “elegance” to concepts like knowledge, justice, or probability, concepts that defy universally accepted definitions. In
other words, they consider “elegance” as an inherent constituent
of thought. I in part dissent with this view because, across
diverse areas of quantitative research – from quantum statistics
to biology and medicine, “elegance” is almost synonymous to
simplicity. In general, scientists and philosophers believe that, at
equal explanatory power, simpler theories are preferable. Theoretical simplicity–or elegance–is a measure of terseness and concision. E = mc2 is a luminous example of ingenious simplicity.
Occam’s Razor, i.e. a principle of logical parsimony used in
problem-solving, clearly establishes that among diverse
hypotheses, the one based on the lower number of assumptions is to be selected. Contemporary justifications of Occam’s
razor, based on the probability theory and statistics, offer
© The Author 2013. Published by Oxford University Press on
behalf of ERA-EDTA. All rights reserved.
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doi: 10.1093/ndt/gft005
Advance Access publication 1 February 2013
The importance of being elegant: a discussion of elegance in
nephrology and biomedical science
1
Department of Philosophy, University of Denver, Denver, CO, USA
Marco J. Nathan1
and
and Diego Brancaccio2
2
Renal Unit Simone Martini, University of Milan, Milan, Italy
Keywords: biomedical science, elegance, nephrology
Correspondence and offprint requests to: Marco
J. Nathan; E-mail: [email protected]
Elegance is pursued and appreciated in virtually all aspects of
our lives, from fashion to visual and performing arts, from literature to architecture. While most of us praise the elegance
and beauty of science when we see it, elegance is typically
treated as something that need not concern our research and
thus does not belong inside the laboratory. In this article, we
provide an alternative perspective, according to which elegance
is more than an accessory ornament of scientific theories. We
endorse and defend the view that elegance is an intrinsic
feature of successful scientific practice and observation, a
benchmark that demarcates between good experiments and
bad ones. In support of our conclusions, we present and
discuss three paradigms of scientific elegance: Jenner’s discovery of vaccination, Bricker and Slatopolsky’s trade-off hypothesis and Brenner’s hypothesis regarding the role of residual
nephrons in the decline of renal function.
INTRODUCTION
Living without definitions
In short, we fall short of rigorous definitions of elegance
per se and of elegant science. Yet, this lack of precise definition
should not frustrate an attempt to examine the importance of
elegance in science. Indeed, one of the important lessons philosophy teaches us is that the search for necessary and sufficient conditions for the application of concepts is often
chimerical and unnecessary. The lack of definitions grounding
basic concepts such as knowledge, justice or probability never
hindered our capacity to engage in meaningful and critical
debates in epistemology, ethics and statistics. The same is true
of elegance. Thus, in the present article, we shall not attempt
to provide an abstract theoretical definition that captures the
‘essence’ or the ‘true nature’ of elegance. More modestly, in
what follows, we shall provide a brief analysis of some
Elegance is pursued and appreciated in virtually all aspects of
our lives, from fashion to visual and performing arts, from literature to architecture. What about science? Can science be elegant?
Prima facie, the answer seems obvious: of course science can be
elegant. Indeed, we all have our favorite examples of elegant
scientific work and the elegance of science is often what fascinates and attracts young scholars, getting them interested in
science in the first place. Nevertheless, upon further scrutiny,
two important questions arise, which are seldom articulated:
what makes science elegant? And why should science be elegant?
What makes science elegant?
With respect to the former question, attempts to isolate the
characteristic features of elegant science are stifled by the
© The Author 2013. Published by Oxford University Press on
behalf of ERA-EDTA. All rights reserved.
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difficulty of providing a clear yet informative definition. Our
inability to define elegance in science (as in all other domains)
is paradoxical. We constantly perceive, recognize, admire and
pursue elegance; yet we seem to be incapable of providing an
adequate definition. Now, surely we can single out some features—such as clarity, geniality and simplicity—that contribute
towards a general characterization of elegant science [1]. Yet
these features can, at best, provide some useful landmarks for
spotting elegance; they fall short of a rigorous definition. For
one thing, all of these properties are no less vague and hard to
capture as elegance itself: dubbing a piece of scientific work as
‘clear,’ ‘simple’ or ‘work of genius’ is as controversial and in
need of clarification as the claim that such piece of work is
‘elegant’. Furthermore, these properties are not specific to elegance as it pertains to scientific research, but can be applied
across the board to identify elegant music, elegant poetry, elegance in fashion and so forth. A characterization so general as
to be applicable to virtually any domain can hardly be employed to single out the defining features of elegance in a field
so diverse, complex and constantly evolving such as modern
science.
A B S T R AC T
paradigmatic instances of elegant science in support of our
main claim, that elegance has an important role to play in
scientific research.
According to a widespread tendency, the elegance of a scientific theory can be identified with its mathematical structure.
This idea is by no means new; it is already present in Leibniz’s
Monadology, where the German philosopher defines the ‘best
of possible worlds’ as that possessing greatest multiplicity and
diversity, harmonized by the fewest and simplest formal (in
general, mathematical) laws. A similar intuition is also found
in Kant’s Critique of Pure Reason, where modern science is
characterized as an enterprise whose basic aim is the unification of phenomena under universal laws. Yet, we contend that
reducing elegance to mathematics overlooks the various facets
and dimensions of scientific elegance. The following examples
emphasize how the elegance of science transcends mathematical simplicity once we move away from the physical science
and focus on biological and biomedical research.
against smallpox epidemics, it could become extremely
dangerous because the—generally mild—infection, could
occasionally (in roughly 2% of cases) become serious, or even
deadly. Furthermore, the exposed subject could herself
become a source of contagion. Jenner employed folk knowledge to find a more effective and less dangerous alternative to
variolation. From the observation that dairymaids infected
with cowpox were also immune to smallpox, he realized that a
disease different from smallpox, though similar in some of its
manifestations, could provide preventive measures against the
devastating disease as effective as variolation, with a much
lower risk of contagion. In other words, Jenner realized that
the cowpox virus causes an immune response that prevents
future infections with smallpox, while, being a different virus,
it does not cause smallpox in the individual, and does not
cause smallpox contagion. The origin of the cure also explains
the name ‘vaccination,’ which derives from the Latin name for
‘cow’ (vacca), the animal which provided the cowpox virus
that is injected in humans by scarification under the skin and
causes an immune response where the antibodies can react
with the smallpox virus. It is said that Jenner himself was so
confident about the efficacy of his method of immunization
that he did not hesitate to vaccinate young boys—including his
own son—and then expose them to smallpox, which they
failed to contract.
Jenner’s intuition, which allowed him to promptly foresee
the wide-ranging clinical applications of vaccination, was undoubtedly important. Furthermore, the anecdote according to
which he was confident enough to vaccinate his own son
added strong drama. Yet, this is only part of the story. It seems
to us that what makes Jenner’s story an effective paradigm of
scientific elegance lies, at least in part, in his ability to capture
the analogy between smallpox in humans and its variants, and
to apply his discoveries in the broader field of immunology.
This goes to show how elegance sometimes emerges in the
form of synthesis—in the literal sense of collecting data and
‘placing them together.’ The elegance of Jenner’s discovery
transcends the mere discovery of a new cure for a deadly
disease. Otherwise, it would be hard to appreciate why vaccination is much more than a substantial improvement in the
longstanding practice of variolation. In addition to its epidemiological control, the discovery of the efficacy of vaccinations
provided an innovative systematization of various disconnected pieces of existing knowledge, opening up new and fruitful avenues for subsequent research.
Jenner’s discovery of vaccination
To begin, let us consider a celebrated chapter in the history
of medicine: Edward Jenner’s discovery of vaccination. Contrary to popular knowledge, the idea underlying the process of
vaccination was not invented and developed from scratch. A
similar practice, called variolation, was widely employed in
various countries, such as China and India, in order to minimize the devastating effects of smallpox epidemics. Variolation
involved the voluntary infection of a person with a mild form
of smallpox, followed by a relatively mild contagion, which
would make the person immune to future infections from the
smallpox virus. While variolation is a relatively effective means
Bricker and Slatopolsky’s trade-off hypothesis
While the history of science is replete with cases of elegance, for our second paradigm, let us restrict our attention to
a more contemporary example: Bricker and Slatopolsky’s
trade-off hypothesis. The fundamental intuition underlying
Bricker and Slatopolsky’s discoveries is the idea that organisms
pay a biological ‘price’ in order to maintain the invariance of
mineral metabolism (calcium and phosphate homeostasis).
The empirical basis of this research was presented in a study
performed in dogs that were experimentally subjected to progressive renal failure [2, 3]. The importance of equilibrium for
the organism was already present in Hippocrates and Galen’s
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The significance of elegance in science
Moving on to the second question raised above, the significance of elegance for scientific research raises an important
and controversial issue. While most of us praise the elegance
and beauty of science when we see it, elegance is typically
treated as something that need not concern our research and
thus does not belong inside the laboratory. We are in the
business of solving problems, finding cures to diseases; we
cannot—and should not—waste our time pursuing elegance.
At most, elegance is treated as an accessory, a way to make the
presentation of our theories more interesting to colleagues,
more palatable to students and more appealing to grant committees and financing institutions. Elegance is not a goal of
scientific research per se. In what follows, we suggest an
alternative perspective, according to which elegance should be
viewed as more than an accessory ornament of scientific theories. We endorse the view that—just like accuracy, generality
and testability—elegance is an intrinsic feature of successful
scientific practice and observation, a benchmark that demarcates between good experiments and bad ones. Hence, elegance belongs inside the laboratory, not to textbooks, coffee
breaks and grant proposals.
PARADIGMS OF SCIENTIFIC ELEGANCE
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M.J. Nathan and D. Brancaccio
ancient theory of humorism [4] and, more recently, in Claude
Bernard’s postulation of the critical importance of the constancy of a milieu interieur for the survival of the organism
[5]. The fundamental step introduced by Bricker and Slatopolsky, however, which lies at the foundation of their trade-off
hypothesis, resides in the intuition that the organism ‘pays a
price’ in order to maintain equilibrium. The currency employed by organisms in such trades is constituted by the progressive increase of parathormone synthesis and secretion by
parathyroid glands in order to increase renal phosphate
excretion. An additional remarkable feature of this series of
experiments was the understanding of the key role of phosphate accumulation, as trigger of a series of biological consequences, leading to secondary hyperparathyroidism.
Bricker and Slatopolsky’s trade-off hypothesis provides an
effective example of how elegance can manifest itself through a
combination of simplicity and equilibrium, which have been
landmarks of elegance long before the 20th century, especially
in connection with the physical and mathematical sciences.
The trade-off hypothesis was a simple idea, if ever there was
one. Yet it required elegant minds to engineer an ingenious
solution to design an experimental model that could then be
effectively applied to clinical practice.
mechanisms of progressive renal failure under non-immunological clinical conditions.
DISCUSSION
Brenner’s hypothesis
As a final paradigm of scientific elegance, let us consider an
important chapter of contemporary nephrology: Barry Brenner’s hypothesis regarding the role of residual nephrons in the
decline of renal function. For those unfamiliar with basic nephrology, nephrons are structured into a cluster of vessels (glomeruli) that filter blood thus producing glomerular urine,
which is then manipulated by tubular structures. Brenner et al.
observed that residual glomeruli are constantly under pressure,
and the amount of pressure is inversely proportional to the
number of glomeruli: the fewer glomeruli present, the higher
the pressure needed to sustain the filtering process [6]. This
observation was confirmed by noting that, in patients lacking
a kidney, the volume of the residual kidney increases, thus supporting the hypothesis of an increased intraglomerular
pressure [7]. Brenner also showed that small-for-date newborns exhibit a reduced number of working nephrons and, as
a consequence, are more prone to experience hypertension
and renal failure throughout their lives [8]. Brenner’s hypothesis for this fact was simple and effective: the fewer the
working nephrons that are present in an individual, the higher
the working load that each nephron has to endure. The increase of intraglomerular pressure deteriorates the glomerular
structures eventually leading to sclerosis and organ failure.
Brenner’s hypothesis was further confirmed and extended by
subsequent work, revealing that proteinuria (a marker of glomerular damage) is also correlated with an increase in glomerular pressure, and therefore, potentially affected by compounds
able to interfere with the renin–angiotensin axis [9, 10].
We maintain that the elegance of Brenner’s hypothesis lies
in a combination of its simplicity and linearity. Despite its remarkable essentiality, it is a unifying hypothesis that contributed to a deeper understanding and explanation of the possible
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All the examples we cited resulted in extremely successful research. Indeed, elegance is often correlated with success;
nevertheless, success in research does not necessarily imply
that the research method or the intuition responsible for the
research was elegant. In a word, elegance should not be
straightforwardly identified with success.
This point is well illustrated by the increasing importance
of mathematical and statistical techniques applied to clinical
research. Most discoveries nowadays are achieved through
plodding repetitive application of some procedure. For instance, one looks at the latest or most promising chemotherapeutic drug. The molecule under scrutiny is then massively
cloned and continuously altered a bit at a time, until a more
promising and effective variant is discovered. When that
happens, scientific progress is undoubtedly achieved. The employment and application of formal techniques divide the
medical community between enthusiastic praises of the objectivity of quantitative methods and skeptical mistrust of statistical tricks [11]. What is indisputable is that statistical
methodology has become a successful and indeed irreplaceable
feature of contemporary scientific research. Yet is this research
elegant? It seems to us that the answer is clearly negative (at
least unless the alteration of the protein is geared towards the
discovery of a new compound that reveals some innovative
therapeutic property that distinguishes it from all the previous
clones). A critical assessment of the role of meta-analysis in
clinical research greatly transcends the scope of this article.
Our point is simply that it is only when the brute force of the
mathematical framework is backed up by some creative act
that meta-analysis can enter the empyrean world of elegance.
What would be a more elegant alternative to the ‘blind,’
mechanistic application of statistical techniques? Imagine that,
instead of producing a massive array of ‘random’ variation of
the existing molecule, a team of researchers could take the
original molecule and engineer a link that allows it to attach
right to the chemical receptor in the target cell. Furthermore,
let us assume that the molecule could be modified in a way
that it perfectly fits the receptor. Ideally, at this point, the researchers could test this single molecule, instead of experimenting thousands of almost-identical clones of the original
protein. It is hard to deny that this more selective alternative
would be preferable: in addition to being more elegant, it
would save the research team a massive amount of time and
resources. The problem, of course, is that this can seldom be
done in practice. Statistical methodology is useful precisely
because we rarely know how to engineer the optimal molecule
to be tested. In such cases, meta-analysis might not be the
ideal strategy, but it is typically the only available one.
We are clearly aware of the fact that a ‘brute force’ methodology
is often the only route to scientific knowledge, and it would be preposterous to flatly criticize the general use of statistical techniques
in medical science. Our remark is simply that contemporary
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research often stops too soon. In the grip of an Academic system
that requires constant results and massive publication records,
much scientific work has fallen short of a full understanding of its
value, and of its placement in a broader spectrum of knowledge.
Comprehending the deeper significance of an experiment often
requires time and patience, even though many contemporary researchers lack the former and ignore the latter. Understanding the
impact and significance of an experiment is frequently tantamount
to innovation and is associated with elegance.
In conclusion, when designing an experiment—be it clinical
or laboratory-based—it is important to take a step back and
look at what one is trying to find, see how it fits in with previous
knowledge or expands it, and whether it can use concepts deriving from different areas of expertize and use them to create a
new experiment that generates greater, novel knowledge. In this
respect, so-called ‘me-too studies’ and other varieties of confirmation protocols constitute a significant and necessary part of
contemporary scientific methodology, but do not belong to the
world of elegant science. In addition, scientific progress also requires original, innovative studies that deepen our foundational
insights. We expect that, while inevitably increasing the time
taken to perform the research, a more consistent pursuit of elegance will lead to a substantial increase in the long-term impact
of published work, which—as revealed even by a cursory glance
at the half-life of articles—has constantly and inexorably decreased over the last few decades. Pursuing elegance is often a
matter of moving away from the microscope and looking into
the telescope. It requires setting some details aside and focusing
on the foundation, structure and architecture of our scientific
work. Details are crucial, but it is easy to get lost in them if we
lose sight of the core message.
With all of this in mind, let us return to the paradigms of
scientific elegance presented above. What all the examples
have in common is the audacity of breaking existing schemata.
Elegant thinkers have been able to go beyond the boundaries
of conventional research, guided by their willingness to open
new avenues of research or shedding new light on old questions. Much of current scientific research is focused on problems that have narrow scope, sometimes too narrow.
Specialization is a characteristic and important feature of contemporary science. However, even if brute-force solutions are
sometimes the easiest route towards solving a problem, we
should also pursue elegance in our work. While meta-analysis
is, and should continue to be, an important tool for scientific
progress, elegance too should leave the textbooks and hallways
and make its way inside the laboratories.
to play in everyday scientific practice, not only when crises
occur. Historical perspective and philosophical reflection are
not tangential, but fundamental components of scientific research. In particular, they allow us to develop the features of
science that make it elegant and better understand why an
elegant mind is a propeller for scientific progress.
AC K N O W L E D G E M E N T S
We would like to express our gratitude to George Dunea, Serafino Garella, Philip Kitcher, Giuseppe Remuzzi and Jere
Surber for constructive comments on various versions of the
article.
REFERENCES
1. Glynn I. Elegance in science: the beauty of simplicity. New York,
NY: Oxford University Press, 2010
2. Slatopolsky E, Caglar S, Pennell J et al. On the pathogenesis of
hyperparathyroidism in chronic experimental renal insufficiency
in the dog. J Clin Invest 1971; 50: 492–499
3. Slatopolsky E, Rutherford W, Hoffsten P et al. Non-suppressible
secondary hyperparathyroidism in chronic progressive renal
disease. Kidney Int 1972; 1: 38–46
4. Nutton V. Ancient medicine. London and New York: Routledge,
2004
5. Bernard C. Introduction à l’étude de la médecine expérimentale.
Paris: J.B. Baillière, 1865
6. Brenner BM, Deen W, Robertson C. Determinants of glomerular
filtration rate. Annu Rev Physiol 1976; 38: 11–19
7. Remuzzi A, Mazerska M, Gephardt GN et al. Three-dimensional
analysis of glomerular morphology in patients with subtotal neprecotomy. Kidney Int 1995; 48: 155–162
8. Luyckx VA, Brenner BM. Low birth weight, nephron number and
kidney disease. Kidney Int 2005; 68: S68–S77
9. Heeg JE, de Jong P, van der Hem G et al. Reduction of proteinuria by angiotensin converting enzyme inhibition. Kidney Int 1987;
32: 78–83
10. Brenner BM, Lawler EV, Mackenzie H. The hyperfiltration
theory: a paradigm shift in nephrology. Kidney Int 1996; 49:
1774–1777
11. Thompson S, Pocock S. Can meta-analysis be trusted? Lancet
1991; 338: 1127–1130
12. Kuhn TS. The Structure of Scientific Revolutions, 2nd edn.
Chicago, IL: Chicago University Press, 1970
CONCLUSIONS
T H E I M P O R TA N C E O F B E I N G E L E G A N T
A systematic study of elegance requires an interdisciplinary approach that involves attention to contemporary biomedical research, a historical perspective, and a philosophical
understanding of the structure and foundations of science. As
Kuhn [12, p. 88] famously remarked, ‘it is … particularly in
periods of acknowledged crisis that scientists have turned to
philosophical analysis as a device for unlocking the riddles of
their field.’ We believe that history and philosophy have a role
NDT ERA-EDTA OLA has selected this publication for
Blog commentary by its faculty in view of its quality and
potential educational value
In this very interesting and original editorial, Nathan and
Brancaccio attempt to fit the concept of “Elegance” into the
framework of medical research, discoveries and advances.
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M.J. Nathan and D. Brancaccio
We, as humans, are attracted to Elegance and Beauty … .
Scientific endeavor whilst being enriched by intuition, lateral
thinking and genial creativity is elegant by itself and beautiful
by its process not by its outlook … .
I beg to differ as I would rather face factually correct
science even though dry and difficult to digest to fanciful
hypotheses that glide through the winds of elegance away from
deeper scrutiny and criticism … .
I opt instead for a Popperian view of science based on the
ugliness of falsiability (4) rather than the elegance of
infaillability … . Falsiability is the elegance of putting forward
quests and hypotheses that are intrinsically challengeable and
subsequently proved false … discovery of truth through stepwise unravelling of falsehoods … Perhaps, the Brenner
hypothesis was both Elegant and False … !?
Professor Meguid El Nahas
Elegance is undoubtedly a reflection of a form of Beauty and
to some Beauty permeates scientific endeavour and quest.
This NDT ERA-EDTA OLA reader may differ from the
authors in the value of Elegance in Scientific Quest
Concern and reservations lie with some of the examples
cited. Some hypothesis can be flawed by elegant … . and thus
is where my concern grows as the elegance and attracted
beauty of the hypothesis can highjack scientific scrutiny …
Take the Brenner hypothesis with its elegance and beauty … .
very intuitive … very attractive … therefore universally accepted without criticism … .in fact those who criticize elegance
and beauty are often dismissed as killjoys … .or grumpy old
men … Elegance and Beauty are overwhelming and are on
occasions at danger of overwhelming reality and true scientific
facts; The Brenner hypothesis, as initially formulated (1), has
been severely and rightly criticized by people like Anil Bidani
who noted in very precise and elaborate experiments, somewhat less elegant and glamorous than the work of Tom Hostetter, Tim Meyer and Barry Brenner, that glomerular
hyperfiltration, hyperperfusion were utterly irrelevant to the
development of scarring in remnant rat kidneys(2); in fact Anderson and Brenner subsequently realized that it wasn’t as
much glomerular hyperperfusion and hyperfiltration that mattered but instead glomerular hypertension (3). Bidani showed
that what truly mattered was systemic hypertension and not
even glomerular hypertension, as remnant kidneys with all the
intra-renal and glomerular adaptive processes did not develop
scarring in the absence of systemic hypertension; the latter a
simple function of the method used to reduce kidney
mass … (2).
So back to concern about Elegance and Beauty masking
simple scientific facts … moreover less Elegant and Glamorous
research and scientific facts being dismissed as of lesser interest and scientific value … .
References
Received for publication: 28.10.12; Accepted in revised form: 21.12.12
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1. Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and
the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive
glomerular sclerosis in aging, renal ablation, and intrinsic renal
disease. N Engl J Med. 1982; 307(11):652–9.
2. Griffin KA, Picken M, Bidani AK. Radiotelemetric BP monitoring,
antihypertensives and glomeruloprotection in remnant kidney
model. Kidney Int. 1994 Oct;46(4):1010–8.
3. Anderson S, Brenner BM. The role of intraglomerular pressure in
the initiation and progression of renal disease. J Hypertens Suppl.
1986 Dec;4(5):S236–8.
4. Popper KR. Science, Problems, Aims, Responsibilities. Fed Proc.
1963 Jul-Aug;22:961–72.