The History of the Dialysis Machine

For patients with kidney disease and kidney failure, the dialysis machine is, literally, a lifesaver. From its development in the first half of the 20th century, advancements in dialysis technology have since made this treatment commonplace for thousands of patients. Without functioning kidneys, a patient would previously have died. Now, life can be extended while a patient awaits a kidney transplant, which often entails a wait of several years.

What is Dialysis?

• Dialysis, more specifically hemodialysis, is the process of filtering toxins and waste from the blood artificially. Normally this function is performed by the kidneys, which on a daily basis process 200 quarts of blood and remove about 2 quarts of waste and water. For patients with kidney disease or acute renal failure, dialysis machines are critical in saving and prolonging life.

  Blood is pumped from the body into the dialysis machine, which separates and filters toxins and waste products, returning clean blood to the body. The separation is achieved via a liquid known as dialysate, which is separated from the blood by a semipermeable membrane allowing toxins and wastes to be drawn out.

Early Dialysis Pioneers

• The term "dialysis" was first used by Thomas Graham, a professor in Glasgow, in 1861. He created a semipermeable membrane out of vegetable parchment coated with albumin, and was able to observe that crystalloids could pass through it.

  The first experiments in hemodialysis were conducted using animals in 1913. The machine created was dubbed an "artificial kidney" and was used successfully. It was never tried on human patients. The creators, however, did note that the machine might be useful in treating human patients, particularly those with kidney damage or failure.

  Human dialysis was first performed by George Haas of Germany in 1924. The dialysis lasted only 15 minutes, and no complications were observed or reported.

First Dialysis Machine

• Dr. Willem Kolff is commonly recognized as the father of the dialysis machine. He began research in the 1930s and constructed the first rotating drum dialysis machine in 1943. Working under Nazi scrutiny in the occupied Netherlands, he constructed the first machine out of common items, including a washing machine, orange juice cans and sausage skins.

  Early results were of limited success until in 1945, a woman in a uremic coma regained consciousness after 11 hours on Kolff's machine. By the end of World War II, Kolff had constructed five of his dialyzers, which he donated to hospitals around the world before moving to the United States to continue his research.

Long-Term Dialysis

• Due to the need to access the bloodstream each time a patient underwent dialysis, doctors in the early days did not consider it a viable long-term treatment. This problem was initially solved by Dr. Belding Scribner with his invention of the Scribner Shunt. The shunt was a U-shaped device used to connect to plastic tubes in the accessed artery and vein in between dialysis treatments. This allowed doctors to use the same access each time dialysis needed to be performed. For some, dialysis became a daily treatment. Even today, dialysis patients are treated at least three to four times per week.

The Next Steps

• Huge strides were made in the second half of the 20th century in the area of dialysis, including the introduction of home dialysis in 1960. This allowed relatives to help a patient receive daily treatments without having to visit the hospital or doctor's office. An alternative type of dialysis, known as peritoneal dialysis also was developed. In this process, the dialysate was injected into the abdomen and filtered the blood without the blood having to be removed from the body.

  Today, focus seems to be on making dialysis machines smaller and more easily accessible. Research and development is ongoing on the potential for a "wearable kidney," a small, externally worn portable dialysis device. This advancement would be a huge step forward for dialysis patients, providing them freedom and mobility to be away from home and even travel, which is difficult with a bulky dialysis machine or when having to visit the hospital several times a week.