The world community of pediatric nephrologists has grown to a great number of active members. A number of them are interested in problems of renal insufficiency and kidney replacement therapy. Therefore, many vital meetings concerning this vibrant speciality have been included in international pediatric congresses. But the discussion of ten-minutes-papers in a large auditorium was often limited, criticism tended to be muted, lively discussions have only occasionally succeeded for the reason that the topics have tended to be too specialized for the audiences in relation to the large number of other discussions about questions and results in pedeatric science. In Cologne, therefore, we decided to hold a conference concerning problems, advances and controversies in renal insufficiency in children, which would have a limited but general audience in rooms of a modest size, topics that tended to polarize a world-wide faculty of experts who liked their basic views to be opposed. The session would be chaired by persons well-known for inciting discussion and even difficult questions in order to stimulate a vital debate between delegates and audiences. One important part of the meeting was therefore the discussion in an open and familiar way as it is known in other workshops. We called the conference "KaIner Kinderdialyse-Symposium". The first conference was held in November 1975, and evoked an extra ordinary enthusiastic response from both audiences and delegates, so we held a second one in 1978 and the third meeting was in 1981.