Treatment of Renal Disease: From Where Does the Opposite View Come?

Professor A.M. El Nahas has recently called for submitting articles concerned with the opposite view in nephrology practice. His call drew attention to several areas of controversy in the art. Also, it brought to mind a question about how an 'opposite view' emanates in a practice that ought to be based on experimental research and rigorous observational studies. This short input addresses the question of how nephrologists decide about management of their renal patients when the literature fails to grant an unequivocal answer to what they should do. It particularly focuses on the need to carefully read the existing literature and to appreciate its limitations. Also, it highlights the iterative nature of controversies in therapy of renal disease and how a controversy evolves into an 'opposite view'.