A Brief History of Dialysis

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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.

Two of the most important dialysis procedures

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As we have seen in previous articles, one of the most important terms in medicine, more specifically in the renal system is dialysis. This is one of the most significant procedures for those people with kidney problems, which gives to them the possibility of having a better health quality and the opportunity for living a more normal life. In other words, thanks to this medical process, people with kidney failures can have a new chance for passing better days.

In this post, we will talk about the two principal dialysis types: the peritoneal dialysis and the Hemodialysis. Before talking about these two vital medical procedures, it is important to have a better context about what a dialysis is and why it is important for those persons with kidney issues. In addition, it is significant to show some other alternatives for the treatment of kidney diseases.

Dialysis and other treatments

We can define dialysis as the medical procedure for cleaning the blood of those people with kidney failures. Put differently, it is the artificial way for eliminating waste and other components in the blood in those persons that have problems in their renal system with the impossibility for removing all these elements by themselves. Usually, the people who need dialysis are the ones with critical renal failures. For those that do not have chronic issues, there are different and less traumatic treatments.

It is important to say, as we have mentioned in this blog, that the renal system is in charge of keeping the right levels of water and minerals in the blood. Through this vital part of the body, elements like potassium, sodium, calcium, chloride, magnesium, phosphorus and sulfate are metabolized, maintaining the required levels of these minerals for the correct performance of the human body. When kidneys and other components of this system are not working correctly for doing this, then a medical treatment is needed. If it is critical, a dialysis procedure will be required.

Having clear what a dialysis is and when it is needed, then we can talk about other renal treatments. Sometimes, when the kidney failure is not so critical, there are medicines that let the renal system to keep the adequate mineral and water levels in the blood. Another alternative is a surgery. One of the best solutions for those persons with kidney failures is a transplant, giving to the affected the possibility of having a normal working in its renal system. However, this is a more complex alternative, due to the high demand of kidneys in the world.

Hemodialysis

Under this procedure, the patient or the affected is connected into a medical dispositive called dialyzer. This mechanism cleans the blood after receiving it from the body. Here, the blood is purified, removing from it all those wasting elements which can not be eliminated by the renal system of the patient. After the blood is cleaned, it is introduced in the body, giving into it the right levels of water and minerals. In other words, through a hemodialysis, the blood is extracted for being filtered and purified in a dialyzer, then it is returned to the body.

Usually, the hemodialysis process is executed in hospitals or medical institutions, but there is the possibility of doing it at home. Some clinics give this alternative to their patients, but it requires a specialized person that understands and know how to make this procedure. It is important to say that a dialysis is usually an outpatient process and can take a few hours to be accomplished.

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Peritoneal dialysis

With a Peritoneal dialysis, the patient can clean its blood through a medical element called dialysate. Basically, with this process, it is introduced glucose through the peritoneal cavity with a tiny tube, so the peritoneal membrane works as a filter, cleaning the blood and purifying it.

This procedure is designed for being applied between 4 or 5 times in a day and for some experts, it is less efficient than an hemodialysis. The Peritoneal dialysis is used not only for cleaning the blood from toxins and other elements, but also for removing excessive fluids and to correct electrolyte problems.

However, this procedure can bring some issues to the patient, like high blood sugar levels, abdominal infections, hernias, abdomen bleeding, or catheter blocking. In other words, the Peritoneal dialysis is an excellent alternative, but for being a medical procedure where a tube is introduced into the peritoneal cavity, some problems may occur.

We have seen in this article two of the principal alternatives for treating kidney issues with dialysis, but there are other processes like the Hemofiltration, the Hemodiafiltration, the Intestinal dialysis or the Pediatric dialysis, which are excellent options depending on the patient and the condition of its renal system. In addition, it is important to say that for those situations where the renal failure is not chronic, other alternatives must be considered, like medicines or surgeries.

Related: Everything You Need to Know About Pediatric Dialysis by Joe Cosgrove

How To Make The Transition To Your Life On Dialysis

Undergoing dialysis treatment is something that will definitely change your life. As we have mentioned here on numerous occasions at Joe Cosgrove’s blog, living with dialysis has a lot to do with adjusting to the new definition of what you consider normal in your daily routine and the way you look at life in general. With that being said, it doesn’t mean that everything you enjoy doing has to stop because of your treatment and that you simply have to adjust to a life that excludes you from things like traveling, eating anything you want and working like everyone else. Dialysis simply becomes part of who you are and the way you go about those activities that bring you joy is just a bit different, even more fulfilling at times.

FAMILY

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One of the biggest challenges of living with dialysis is probably one of the things that has to do the least with the treatment itself, and that is accepting it. Dialysis is a big word that conjures up images of sickness, needles, hospitals and pain; most of that has to do with a bad reputation that it has acquired over the years and just the ignorance sported by the general population when it comes to kidney disease. These types of treatment exist to make you better and every single day there are brilliant minds and large amounts of resources working hard at advancing this processes even more with the aid of cutting-edge technology in an attempt to give patients a better quality of life and a warmer acceptance of what living with dialysis means.

Today on our blog, we want to talk a little about the beginning of your life with dialysis and what you should expect in the first couple of months while you get used to it so you can make the best out of this challenging time in your life.

Understand the alternative

Dialysis is a relatively new treatment and before that, there was nothing that you could do for patients with kidney failure, something that pretty much meant that you were looking forward to an extreme decline of your health and most likely dying from your condition. Today dialysis can not only keep you alive, but it can do with while giving you a considerable quality of life as it becomes such a manageable part of you, that you will simply come to live with it seamlessly.

The dialyzer has limits

The machine that is helping you clean your blood during the dialysis treatment is not a magical device that can completely replace your kidneys. Kidneys are truly remarkable organs and are able to withstand a lot of damage before failing, they are truly irreparable and no machine exists that can do what they do as well as they do it. Understanding that is crucial for you to realize that while internally there isn’t much else you can do to help your kidneys other than undergoing the treatment, externally there is a lot you can do to compensate for the dialyzer shortcomings. Things like eating healthy, exercising and taking care of yourself so as to alleviate the stress your body has to go through are great ways to making sure that all your efforts are directed towards making the treatment work as well as it possibly can.

Find ways to make yourself comfortable

Yes, you are just lying down and reading or watching TV waiting for the treatment to be over, but as you are apparently relaxed and not doing much, your body is working overtime dealing with everything that is going on. Your blood is being extracted, cleaned and then pumped back into your body constantly during a session that may last up to four hours, this means that your body has to take all these in and push itself to compensate. It is very common to feel tired even if you think you did nothing during the day. Give your body time to get used to the changes.

Lean on your support network

Give the people in your life who care about you the opportunity to be there with you and to participate in whichever way you think it will make the process easier for you. Those around are also affected in their own way, so make sure you don’t neglect this support network and allow it to help you get through the tough times. People in the dialysis community are also very supportive of new members and will answer your questions and take you in if you need anything. You should take advantage of their experience and knowledge dealing with dialysis and even share with them the ways that you are making it work for yourself. Remember you are not alone in this and the condition can be a bonding experience with your family, friends and other loved ones.