A Brief History of Dialysis

National Museum of Health and Medicine_kidney

Image courtesy of MilitaryHealth at Flickr.com

Dialysis is a procedure commonly used to help filter the waste present in the blood when the kidneys simply can’t do it. As a medical procedure, it has been around for more than 70 years, helping patients have normal lives or at least livable ones.

Like most medical procedures, dialysis also has a story to be told, one that dates back to the 1940’s when the first dialysis machine was invented by a Dutch physician called Willem Kolff. Since the day this first machine was invented, to nowadays, dialysis has evolved incredibly, reaching the point where many patients are able to live with it for many years and still have regular lives.

In this article, Joe Cosgrove will share a bit of history related to dialysis and the great impact is has had in medical history and the lives of millions of people in time.

The 1940s: The beginning

At the beginning of the 1940’s a physician named Dr. Willem Kolff invented a device that worked as an artificial kidney. Thanks to his invention, Kolff is considered to be the pioneer of dialysis. As a physician, Kolff spent about 10 years of his career developing an artificial kidney in the Netherlands while working at the University of Groningen Hospital. He was first inspired to create this type of artifact when visiting the University Hospital and watching how a young man would irremediably die because his kidneys couldn’t filter waste anymore.

Once motivated to create something that could help those experiencing kidney failure, Kolff decided to go to research about ways to remove waste from the blood once the kidneys stopped working. Then he found an article written by the pharmacologist John Abel in 1913 about hemodialysis in animals. Thanks to this article, Kolff dedicated himself to the cause of developing an artificial kidney for humans.

Kolff had a hard time developing this device since he was sent to a remote hospital to serve at during war. Despite the poor conditions he kept on moving forward and improvised many times with many different materials (including sausage skins) to create something that could remove waste away from the blood.

By the year 1943 and after overcoming a great share of difficulties, Kolff’s invention was finished and was tested without any success on numerous patients, until in 1945, it helped an old woman overcome a uremic coma.

The machine Kolff invented is considered to be the first dialyzer of our times and its structure remained almost untouched for ten years as the best alternative for physicians to treat patients who were suffering from kidney failure. Probably Kolff didn’t know it back then, but his machine turned out to be one of the most important medical inventions in history and helped to save the lives of thousands.

The 1950s: Evolution of the dialyzer

At the beginning of the 1950’s, Kolff’s dialyzer had already been improved and used to treat injured soldiers fighting during the war. It had also been used to treat end-stage renal disease and acute renal failure patients. However, during the middle of the 20th century, not many doctors were optimistic about the usage of Kolff’s dialyzer because they believed a human made machine couldn’t resemble the kidneys’ function and they also found it difficult for the human veins to stand such treatment in the long term.

It was in Boston where a professor named Dr. Belding Scribner came up the idea of plugging the patient to the dialyzer by using flexible tubes made of a new plastic called Teflon. This way the tubes could be introduced inside the arteries and veins, keeping the circulatory access opened thanks to the usage of a tiny device with the shape of a “U”. This u-shaped device was called The Scribner Shunt.

By using this device patient no longer needed to get a new incision when going under the dialysis treatment. Even though this method isn’t used today, it helped other doctors develop new techniques to access the circulatory system that were useful to treat those who had acute kidney failure.

The 1960s: A decade of changes

Scribner was the first person on earth to open a dialysis facility in 1962. Problems started to appear when the number of patients who wanted and needed to be treated exceeded the capacity of the clinic – with only six available machines. Scribner needed to find a way to decide which patients were getting the dialysis done since many of them actually were close to death.

By this moment, Scribner decided to create an anonymous committee of people who could make that decision for him. This committee was composed of local people and doctors who worked in the kidney fields. Although this Solomonic choice created controversy, in time this committee was seen as the first bioethics committee of all time and changed the relationship common people had with the offer of health services.

The Past 60 Years

During the past 60 years, the history of dialysis has gone under several changes, new machines have been developed, new materials have been invented and many people in the world depend on this treatment to survive. We still know medical pioneers like Kolff or Scribner that are concerned about the way medicine evolves and is being practiced.

It is always expected in the future to come for specialists to be able to create new solutions that may help patients live longer, happier and have regular lives despite the fact they need to undergo dialysis treatment several times per week. History is still being written and hopefully, the years to come will be full of great surprises in this important medical field.

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