{"doi":"10.1111/nep.14341","title":"My lifetime in <scp>IgA</scp> nephropathy: An <i>unexpected</i> journey","abstract":"My unexpected journey began when my wife, Rachel and I in 1975 pursued our post-doctoral medical training at the University of Kentucky, hers in psychiatry and mine in internal medicine. I planned to be a general practitioner in a small town. In 1978, Rachel unexpectedly decided to extend her training to 4 years, 1 year more than my three-year residency. Instead of a one-year position as an internist in the emergency department of a local hospital, I started a two-year fellowship in nephrology during which time I encountered many patients with IgA nephropathy. I worked with Robert J. Wyatt, a paediatric nephrologist at the University of Kentucky, who investigated complement's role in kidney disease. In the middle of my fellowship training, four nephrology faculty unexpectedly moved to the University of Alabama at Birmingham (UAB). I remained in Lexington rather than relocating to Birmingham to complete my fellowship because our first son arrived in May 1979. In 1980, after completion of my fellowship, Rachel and I explored multiple options for employment in several states. A new choice emerged unexpectedly when John H. Galla, who had been a mentor throughout my fellowship and had decided to join a new nephrology group in Lexington, changed his plans. After extensive discussions, he opted to reunite with former faculty colleagues in the Division of Nephrology at UAB. I took his place in the private-practice group. Over the next 2 years, I encountered many patients with IgA nephropathy. Through contact with Galla, I started to participate in clinical research with Jiri Mestecky at UAB, an expert on the immunobiology of IgA. In 1982, I biopsied a patient with IgA nephropathy who then informed me about her first cousin with the disease whom I had biopsied about 6 months earlier. Several other relatives had undefined kidney disease. Over the next year, I worked with Wyatt, Patricia A. Quiggins—a graduate student in anthropology, and Susan Y. Woodford—a research nurse in the Division of Nephrology at the University of Kentucky to document the familial relationships of the two first cousins with their relatives with kidney disease. We found that their pedigree included several more members with IgA nephropathy and others with clinical glomerulonephritis who had not undergone a kidney biopsy. In 1983, I attended the 1st International Symposium on IgA Nephropathy in Milan, Italy. I had purchased a ticket for ‘Lunch with the Experts’ and took the opportunity to show a hand-drawn pedigree to Jean Berger and Anthony R. Clarkson. Their enthusiasm for evidence of a genetic influence on IgA nephropathy was the driving force for me to devote more time to research. During the next few months, Wyatt, Quiggins, Woodford and I continued to define the relationships in the multiplex family. We identified 6 members with IgA nephropathy, 14 with clinical glomerulonephritis and 5 who had ‘chronic nephritis’ listed on their death certificates. In late 1983, Rachel, a board-certified psychiatrist, unexpectedly told me I was ‘crazy’ to continue research in a busy small private-practice group. Within a week, I called UAB Nephrology to ask about joining the faculty. In the summer of 1984, I sent a manuscript produced on a manual typewriter with the multiplex Kentucky pedigree to the New England Journal of Medicine for consideration for publication. One month later, Rachel and I joined the faculty at UAB. The paper with the pedigree was published in January 1985.1 During the next 2 years, we discovered that the expanded pedigree included 29 patients with IgA nephropathy.2 Remarkably, 48 of 80 patients born in eastern or central Kentucky had at least one relative with IgA nephropathy.2 During the ensuing 38 years, I collaborated with many gifted researchers and physicians at UAB, University of Tennessee-Memphis, and Columbia University, and in Canada, Czech Republic, France, United Kingdom, Italy, The Netherlands, China, Germany and Japan. The evidence of a ","journal":"Nephrology","year":2024,"id":503944,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9583,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":71222,"name":"Bruce A. Julian","orcid":"0000-0001-5781-1021","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T02:10:35.597333Z","pmid":"39327736","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}