13 May

The History of Dialysis

Dialysis is the process of removing toxins, solutes, and excess water, from the blood in people whose kidneys can no longer perform these functions naturally. This is also known as renal replacement therapy. Modern-day dialysis treatment looks a lot different than where things started over 100 years ago. In this article, we will take a look at the history of dialysis, including the early days of dialysis up to modern-day dialysis treatment options.

The History of Dialysis

Early Days of Dialysis

The history of dialysis starts with Leonard Rowntree and John Abel of Johns Hopkins Hospital. These individuals were able to develop the first successful dialysis system (animals) in 1913. Willem J. Kolff, a Dutch doctor constructed the first working dialyzer. Dr. Kolff came to the United States in the 1940s and conducted several experiments that eventually led to an improved design built in the 1950s. Sausage casings, beverage cans, a washing machine, and other items available at the time made up the initial machine. Over the following two years (1944–1945), Dr. Kolff used his machine to treat 16 patients suffering from acute kidney failure, but the results were unsuccessful.

The first successful dialysis treatment

In 1945, there was a major breakthrough that changed the history of dialysis treatment. Dr. Kolff achieved success, when a 67-year-old comatose woman regained consciousness after receiving 11 hours of hemodialysis with the dialyzer. The woman lived for another seven years before dying from an unrelated condition.

Further Developments

Gordon Murray working at the University of Toronto independently developed a dialysis machine in 1945. However, unlike Dr. Kolff’s rotating drum, Murray’s machine was a more modern design that used fixed flat plates. As with Dr. Kolff, Murray’s initial success was in patients with acute renal failure. Later on, Nills Alwall, from Lund University in Sweden, modified a similar construction to Dr. Kolff’s dialysis machine by enclosing it inside a stainless-steel canister. This allowed the removal of fluids, by applying negative pressure to the outside canister, thus making it the first “practical” device for hemodialysis. Alwall’s first patient in acute kidney failure received treatment in September 1946.

Vascular Access and Chronic Dialysis

It is important to note that early devices in the history of dialysis only treated “acute kidney failure”, not end-stage renal disease (ESRD). In fact, the first official dialysis clinic to treat ESRD in the US was opened in 1962 by Dr. Belding Scribner, a professor of medicine at the University of Washington. Dr. Scriber developed a way for ESRD patients to receive treatment through an access point in their arms. Dr. Belding eventually went on to develop a portable dialysis machine that allowed patients to receive dialysis treatment at home. By 1973, approximately 40 percent of dialysis patients were doing their treatments at home! Studies have shown that increased treatment length and frequency are more clinically beneficial to patients.

Additional Reading: Home Hemodialysis – National Kidney Foundation

Modern Dialysis

Today, the great majority of patients are receiving their treatments in dialysis centers. This is true even though many more treatment options have become available. Other dialysis treatments include transplant, nocturnal in-center treatment, home hemodialysis, and peritoneal dialysis. In contrast to the early years of dialysis presented here, the lack of adequate treatment methods or technologies is no longer a challenge in the treatment of kidney patients. It is important that we remember the early days of dialysis treatment and how far we have come by learning the history of dialysis in order to fully admire the treatment options we have today.

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