The Father of Dialysis

[Zach]

As many of you know, Willem J. Kolff is considered the father of dialysis.

Here's his account on the development of the artifical kidney.  It's from a 2002 edition of Nature Medicine.

I thought we might want to reflect on his work ...

http://www.nature.com/nm/journal/v8/n10/full/nm771.html

[Epoman]

http://www.achievement.org/autodoc/page/kol0int-1 - a very nice biography of a great man, thank you Mr. Kolff for making it possible for me to see my son grow up. Sorry about the websites name, but I'm sure you understand. 

[livecam]

I've read about him before and if I am correct he is still alive which is pretty impressive since he began his dialysis experiments in the early 1940's.  I remember a dialysis nurse who was working as early as the 1960's.  She said dialysis back then was extremely crude compared to what we have today.  In the 40's it was downright primitive and only used in cases of acute kidney failure where recovery was thought to be possible.  Chronic hemodialysis didn't begin until much later and then only on a very limited basis.  Back then there literally were "death" commitees who decided just who would get dialysis and who wouldn't.  Most didn't make the cut.

[Epoman]

I've read about him before and if I am correct he is still alive which is pretty impressive since he began his dialysis experiments in the early 1940's.  I remember a dialysis nurse who was working as early as the 1960's.  She said dialysis back then was extremely crude compared to what we have today.  In the 40's it was downright primitive and only used in cases of acute kidney failure where recovery was thought to be possible.  Chronic hemodialysis didn't begin until much later and then only on a very limited basis.  Back then there literally were "death" commitees who decided just who would get dialysis and who wouldn't.  Most didn't make the cut.

Yes he is still alive. 

[angieskidney]

Wow! Very good links! I have been reading and discovered that he was Dyslexic like me? Wow!

That's right. I have a problem, which is in my family. It's called alexia or dyslexia. I can spell difficult words, but at this time I cannot tell you whether "always" is spelled with one "l" or two "l's". This plagued me a great deal. There was one teacher who I had problems with. Out of all my work in the final examination, he made me accountable for the spelling errors, which I thought was a mean thing to do. I like to read, but I read slowly. I know the literature about artificial kidneys and artificial hearts quite well.

It just goes to show you that nothing should stop you I think that story is especially inspiring for any doctor to read!

[Dr. Evil]

Actually, there are several key players.

Belding Scribner (...ever heard of the 'Scribner Shunt")....is one of the key players.  He was instrumental in developing dialysis for chronic use.
(Perhaps you way want to curse him....)

Either way....he envisioned routine outpt dialysis and developed the external hemodialysis silastic access that made routine dialysis possible.

Search the web to find info.....He recently died....he did most of his work in Seattle, WA.
Funny guy too...some great interviews with him have been published.

[kitkatz]

If I saw one of those drums in the picture and was told I would be hooked up to it...I don't know if I would have done it. Looks midevil.

[angieskidney]

I heard that hemo dialysis USED to look like a washing machine! What a good read!

[Rerun]

Actually, there are several key players.

Belding Scribner (...ever heard of the 'Scribner Shunt")....is one of the key players.  He was instrumental in developing dialysis for chronic use.
(Perhaps you way want to curse him....)

Either way....he envisioned routine outpt dialysis and developed the external hemodialysis silastic access that made routine dialysis possible.

Search the web to find info.....He recently died....he did most of his work in Seattle, WA.
Funny guy too...some great interviews with him have been published.

I was in a small bible study in Davis, CA (Home of UC Davis) and when the host "Annette Parker" heard I was losing my transplant she took me aside and told me her husband Howard Parker (??) worked side by side Belding Scribner on the shunt.  They practiced on sheep at UC Davis before they used it on humans.  They were invited up to University of Washington to work there for about a year.  He has passed away too.  But I felt honored to be in his home.

[Zach]

Here is more information on Scribner and beyond.

http://www.washington.edu/research/pathbreakers/1960c.html

[stauffenberg]

One of the most important things about Willem Kolff was that he was horrified to find dialysis machines being used for long-term care of patients in end-stage renal disease, since he found this to be an inhumane misuse of his invention.  As far as he was concerned, the dialysis machine should only be a brief, bridiging therapy for patients with acute renal failure.

[ahamner]

I remember a dialysis nurse who was working as early as the 1960's.  She said dialysis back then was extremely crude compared to what we have today.  In the 40's it was downright primitive and only used in cases of acute kidney failure where recovery was thought to be possible.  Chronic hemodialysis didn't begin until much later and then only on a very limited basis.  Back then there literally were "death" committees who decided just who would get dialysis and who wouldn't.  Most didn't make the cut.

I was interviewed by such a committee in 1965 when my father's kidneys had failed as a result of PKD.  He was given dialysis treatments a couple of times in the hospital while he was being evaluated.  I remember they used both hemo and peritoneal types. As I can remember the fluid was contained in glass bottles.  After the dialysis treatments  he seemed like a new man health wise.

When the "committee" made the decision to send him home we knew he was going to die at age 48.  The first few days at home he was great then his health started failing.  It was so sad knowing their was something available to save him but it was withheld for lack of resources.

[scyankee]

ahamner,
   My Dad also died at age 48 from PKD. I was too young to know that he was even ill much less know
if he had the option of dialysis in 1959.  I can only pray that he did not suffer too much.
  SCYankee

[angieskidney]

One of the most important things about Willem Kolff was that he was horrified to find dialysis machines being used for long-term care of patients in end-stage renal disease, since he found this to be an inhumane misuse of his invention.  As far as he was concerned, the dialysis machine should only be a brief, bridiging therapy for patients with acute renal failure.

Ya but I bet he didn't predict just how many people would have to wait years for a transplant.

[Bear]

Excerpt from MR.Kolff's essay -  "Using the Wearable artificial kidney, we could send patients on what we called 'Dialysis in Wonderland' trips. In 1 year, we made 28 such trips. Patients would raft down the Colorado River and dialyze themselves on shore, or they would drift down the Salmon River in Idaho and live on a houseboat on Lake Powell or go to the Bahamas or Hawaii, dialyzing in the mornings and perhaps water-skiing in the afternoons. These 'Dialysis in Wonderland' trips were excellent programs to rehabilitate renal patients and show them that despite their kidney problems, they could still enjoy life. "
 ...yes. wonderful. SO...er....where is the 21st century update on this little item & why are we not all charging about the place wearing them !??? 
 ...I'll gladly do Hawaii, or the Salmon River houseboat trip, thanx. 

[angieskidney]

Excerpt from MR.Kolff's essay -  "Using the Wearable artificial kidney, we could send patients on what we called 'Dialysis in Wonderland' trips. In 1 year, we made 28 such trips. Patients would raft down the Colorado River and dialyze themselves on shore, or they would drift down the Salmon River in Idaho and live on a houseboat on Lake Powell or go to the Bahamas or Hawaii, dialyzing in the mornings and perhaps water-skiing in the afternoons. These 'Dialysis in Wonderland' trips were excellent programs to rehabilitate renal patients and show them that despite their kidney problems, they could still enjoy life. "
 ...yes. wonderful. SO...er....where is the 21st century update on this little item & why are we not all charging about the place wearing them !??? 
 ...I'll gladly do Hawaii, or the Salmon River houseboat trip, thanx. 

Ya that is exactly what I thought as well once I read that

[Zach]

One of the most important things about Willem Kolff was that he was horrified to find dialysis machines being used for long-term care of patients in end-stage renal disease, since he found this to be an inhumane misuse of his invention.  As far as he was concerned, the dialysis machine should only be a brief, bridiging therapy for patients with acute renal failure.

Interesting.  Can you site the source of this statement about Kolff being horrified?

[Mom3]

I was privileged to meet him at a convention once. He certainly didn't seem horrified... Did he perhaps change his attitude as new drugs and machines were developed?

Mom 3

[angieskidney]

I was privileged to meet him at a convention once. He certainly didn't seem horrified... Did he perhaps change his attitude as new drugs and machines were developed?

Mom 3

Wow you got to meet him? That is so cool!

[Rusty]

I heard that hemo dialysis USED to look like a washing machine! What a good read!

 
That's because it really was a washing machine.  A converted Maytag.  The patient's pulse did the pumping, and a treatment took almost all day, every other day.  On the off days the patient and a helper spent most of that day constructing kidneys using sausage casings.

[Zach]

Hmmm ... sausage.  I'm getting hungry.     

[ArmyRN]

I also met Dr. Kolff during a conference. He is a very nice man. I also was able to see his original machine last year during a meeting in Tampa, Florida. Regarding using Maytag as dialysis machines, Maytag was approached to build dialysis machines but they did not want to get into the medical business. The first machine I used was the Drake-Willock (1973) using the Coil dialyzers. This machine was good and dependable. The Coil dialyzers were not.

[Rusty]

Hmmm, I guess I had some faulty info about the Maytags.  Sorry about that.  I learned it at a symposium for patients, family, and dialysis workers that we had in town a couple of years ago.

[Zach]

One of the most important things about Willem Kolff was that he was horrified to find dialysis machines being used for long-term care of patients in end-stage renal disease, since he found this to be an inhumane misuse of his invention.  As far as he was concerned, the dialysis machine should only be a brief, bridiging therapy for patients with acute renal failure.

Interesting.  Can you site the source of this statement about Kolff being horrified?

I've done extensive research and have found no indication that Willem Kolff "was horrified to find dialysis machines being used for long-term care of patients in end-stage renal disease."

Were you telling a fib?     

[Zach]

Some food for thought:

http://ihatedialysis.com/forum/index.php?topic=1795.msg24049#msg24049

The inventor of the modern form of dialysis, Willem Kolff, thought it was being abused when used for long-term therapy, and viewed it instead as appropriately used only for acute dialysis in patients for a short time.

Please link us to that quote.

Personally, I don't believe you have your facts straight about Willem Kolff thoughts about using his invention for long-term therapy.  Please show us the exact quote from a reputable publication.

"Here's a real quote from Kolff, from the biography on the Academy of Acheivement website - "The exciting thing is to see somebody who is doomed to die, live and be happy."

And this, from the biography on the same page-
Over the opposition of many physicians, Dr. Kolff wanted to give the patient more control of the process, so patients could perform their dialysis at home, without a doctor's supervision. In 1975, he introduced the Wearable Artificial Kidney, an eight-pound chest pack with an 18-pound auxiliary tank."

If he only wanted it used for short term, why would he make a home unit?

And from the bio an the Membrana website (they make the filters used in dialysis)      
                     

"Among his patients in Groningen was 22-year old Jan Bruning, who was dying slowly and painfully from kidney disease. The young Dr Kolff realised that if he could remove the toxins gradually building up in the young man's blood, which would normally be removed by the kidneys, he could be kept alive - but there was no technology available at the time to accomplish such a task. "I felt helpless telling his poor mother there was nothing we could do for him" wrote Dr Kolff many years later. This was the trigger that started Dr Kolff experimenting with a device that could temporarily replace the kidney in removing urea and other excretory products from the body. "

His reason for starting the research in the first place was a patient with chronic, not acute kidney failure.

Sorry stauffenberg - unless you can come up with another quote. . .I don't buy your take on Kolff.