Hrvatska pedijatrijska nefrologija od 2000. do danas: od nacionalne mreže do personalizirane medicine

Introduction: The history of Croatian pediatric nephrology after 2000 is not the history of a single institution or generation. It is the story of a field that connected clinical schools, built a national network, and brought contemporary nephrology care closer to children throughout Croatia. Objective: To describe the development of Croatian pediatric nephrology from 2000 to 2026, the contributions of national and regional centers, and the changes that led toward more accessible, less burdensome, and personalized care. Methods: Data were collected from the available professional and scientific literature, hospital monographs, online and institutional sources, and archival documentation. Because adequate published or archival records were unavailable for some events, personnel changes, and introductions of methods, the account was supplemented by written testimonies, oral professional history, and personal communications with physicians directly involved in the development of the field. The review covers the period from 2000 through September 2026. Development overview: The Croatian Society for Pediatric Nephrology, founded in 2001, connected centers and regional clinics and strengthened education, standardization, and knowledge transfer. Dialysis, transplantation care, genetic diagnostics, and treatment of complex kidney diseases advanced alongside methods without ionizing radiation. Distinct Croatian contributions during this period included the standardization of contrast-enhanced voiding urosonography (ceVUS), development of videourodynamics with ceVUS, and research on intrarenal reflux that enabled more precise risk assessment and prompted a proposal to extend the classification of vesicoureteral reflux. Functional diagnostics, radiation-free methods, urotherapy, neuromodulation, and less invasive treatment changed the approach to urinary tract infections, vesicoureteral reflux, urinary tract anomalies, and voiding disorders by integrating anatomy, function, and individual risk. Conclusion: Over a quarter of a century, Croatian pediatric nephrology changed both the possibilities of treatment and where children could receive care. Its greatest achievement is not a single method, but a network of knowledge linking tertiary centers with physicians close to the child's residence. This history is not complete: it is a legacy and a responsibility to continue advancing and sharing knowledge and to make it available to every child in Croatia.