The Emperor's new clothes in nephrology Past and present

Evidence-based Medicine has been described as the integration of information from best available evidence with the doctor's experience and the patient's point of view. If it is replaced by Guidelines-based Medicine it resembles the Hans Christian Andersen's fairy tale the "Emperor's New Clothes" where the Emperor (our Healthcare) is naked and nobody dares to cry it out. History has made circles since "Authority" based Medicine of the Past has been replaced by "Guidelines", if followed blindly. We searched for such examples in the Past and the Present in the field of Nephrology. Galen's and Aristotle's sayings were not contradicted by their successors, in the "shadow" of their prestige and their "Authority", even though ironically both actively encouraged experimentation and the questioning of established theory. In the present treatment of hyperphospatemia with Phosphate binders and dyslipidemia with statins in Dialysis patients are two examples where in clinical practice the doctor and the patient are not in the centre of the decision process. In conclusion we should hear the voices that cry out"the Emperor is naked"and as a recurring historical cycle turn to Hippocrates' Oath ordering us to apply the best possible treatment to our patients.