The Father of Dialysis

[angieskidney]

Maybe it was only about how so many patients are on dialysis and more should be transplanted? I still can't find where i saw something along the lines.

[stauffenberg]

Actually the very first form of medical dialysis was performed in the first years of the 20th century, but not for renal patients.  Instead it was a form of peritoneal dialysis performed on diabetics in an effort to reduce the risk of coma from acidosis due to the accumulation of ketones.  The dialysate fluid contained a large supply of sodium bicarbonate to correct the hyperacidity.

[Zach]

I think we always need to have a sense of history, so I brought this thread back for more comments.

[Bill Peckham]

I was lucky enough to meet Dr Scribner and his wife Ethel, visiting them on their house boat several times. The first time I met him he said hello and then asked if he could take my blood pressure. Uh oh, pop quiz. I was lucky that day 120s over 70s. Lucky because I knew Scribner looked to blood pressure control as the surest sign of adequate dialysis. Adequate dialysis.

To this day I use the Scribner Hemodialysis Product to reckon how a change in schedule will impact the dose of dialysis I am receiving. Scribner is a personal hero of mine. Not only did he come up with a way to access the blood again and again over time he gave that idea to the world. There is no patent on the Scribner shunt. Scribner’s egalitarian vision didn’t stop there he also conspired with others e.g. James Haviland to build a community based non-profit organization to provide the dialysis.

This organization was the Seattle Artificial Kidney Center, today’s Northwest Kidney Centers. You can read our history here: http://www.nwkidney.org/about/history/index.html NKC has had a pioneering role in the history of dialysis. This is our 45th year.

Full disclosure: I say our because I serve on the NKC Board of Trustees and have a personal sense of pride of ownership.

[stauffenberg]

Actually the first form of dialysis to be available was peritoneal dialysis, which used to be used ca. 1900 to treat diabetics in danger of falling into acidosis by withdrawing toxins from their abdomen.  There were many primitive versions of dialysis machines from that time forward, but since the doctors had to cut down to the blood vessels to connect the patient each time, dialysis was only used for acute interventions, as when there was temporary loss of renal function from a crushing injury.  Kolff was more like an Edison than an Einstein, in that he achieved a significant advance in technological refinement of an established concept, rather than introducing a revolutionary, new concept.

[okarol]

Very compelling article. I was interested to read:

Dialysis three times a week is a poor substitute for continuous dialysis in replicating the uninterrupted removal of waste products that our natural kidneys provide. Continuous dialysis all the time would be preferable and might be possible if wearable artificial kidneys were provided. As this is not possible, at present we should aim for daily dialysis; the most practical way seems to be to do it at the end of the day. Home dialysis affords better opportunities for daily dialysis, but unfortunately seems to be more expensive for patients than dialysis in centers. At one time, the government provided paid, trained helpers for home dialysis; this should be reinstituted.


This is still a goal, I think, to achieve the best dialysis. And trained home helpers... wouldn't that be nice?