Dialysis is Now Old Enough to Have Its Own Museum

You know kidney disease advocates sort of bond together, right? I somehow magically ran across Steve Weed, a two time transplant recipient who has his own web development company that specializes in social media planning: Landau Digital Solutions. Actually, he unwittingly led me to the publisher of my first book: What Is It and How Did I Get It? Early Stage Chronic Kidney Disease before I even knew what he did for a living. But I digress.

While recovering from his recent transplant, Steve posted about visiting a dialysis museum. I found myself mystified that such a thing existed. Wasn’t dialysis only about fifty years old? Who had a museum about such a young invention?

Then I realized that I had never written about the history of dialysis. Maybe it was older. So I did a little digging for us. Will you look at that! The idea of dialysis is much older than I’d thought. This is from Renal Med at http://www.renalmed.co.uk/history-of/haemodialysis:

“Scottish chemist Thomas Graham, known as the ‘father of dialysis’, first described dialysis in 1854. He used osmosis to separate dissolved substances and remove water through semi-permeable membranes, although he did not apply the method to medicine

He worked as a chemist in Glasgow University at around the same time as physician Richard Bright was describing the clinical features and diagnosis of renal failure in Edinburgh. He noticed that crystalloids were able to diffuse through vegetable parchment coated with albumin (which acted as a semi-permeable membrane). He called this ‘dialysis’. Using this method he was able to extract urea from urine. Graham prepared a bell-shaped vessel….”­

This was the seed that later became hemodialysis, which is defined by MedlinePlus (part of the U.S. National Library of Medicine) at https://medlineplus.gov/dialysis.html in the following way:

“Hemodialysis uses a machine. It is sometimes called an artificial kidney. You usually go to a special clinic for treatments several times a week.”

The difference in spelling is due to the variations between British English and American English.

Another step in dialysis becoming dialysis as we know it today is:

“The first human hemodialysis was performed in a uremic patient by (Me: His given name is Georg.) Haas in 1924 at the University of Giessen in Germany…. He used a tubular device made of collodion immersed in dialysate solution in a glass cylinder. Haas was able to calculate that the total non-protein nitrogen removed was 2,772 g. He also showed that the presence of some uremic substances in the dialysate and that water could be removed from the blood. In 1928, he first used the anticoagulant, heparin. In 1937, the first flat hemodialysis membrane made of cellophane was produced, which is produced in similar manner to cellulose, but dissolved in alkali and carbon disulfide…. The resulting solution is then extruded through a slit and washed multiple times to obtain a transparent semipermeable material.”

I found the information on the Advanced Renal Education Program site at https://www.advancedrenaleducation.com/content/history-hemodialysis.

Then, finally, dialysis as we know it. DPC Education Center (Dialysis Patient Citizens) at http://www.dpcedcenter.org/brief-history-dialysis provided this information.

“The history of dialysis dates back to the 1940s. (Me here again: although we know the seeds for the dialysis were planted much earlier.) The first type of dialyzer, then called the artificial kidney, was built in 1943 by Dutch physician Willem Kolff. Kolff had first gotten the idea of developing a machine to clean the blood after watching a patient suffer from kidney failure. When his invention was completed, he attempted to treat over a dozen patients with acute kidney failure over the next two years. Although only one treatment turned out successful, he continued to experiment in improving his design.”

The sources use many words you may not be familiar with. IvyRoses at http://www.ivyroses.com/HumanBody/Urinary/Urinary_System_Kidney_Dialysis.php was able to help us out here.

Parts of a Kidney Dialysis Machine

Dialysis Membrane (sometimes referred to as simply a ‘dialyser’)
Note that there are two types of artificial kidney dialysis in clinical use: Hemodialysis uses a cellulose-membrane tube immersed in fluid, whereas peritoneal dialysis uses the lining of the patient’s abdominal cavity (peritoneum), as a dialysis membrane. This section … only describes the case of hemodialysis.
The “dialyser” part of a kidney dialysis machine consists of a large surface area of cellulose acetate membrane mechanically supported by a plastic structure. Blood is pumped past one side of this membrane while the dialysate fluid passes on the other side. The membrane may be folded-over many times so that the large area of the membrane occupies a practical volume of space.

Dialysate
The dialysate (solution) has the same solute concentrations as those in ordinary plasma. Therefore if the patient’s blood plasma contains excess concentrations of any solutes, these will move into the dialysate, and if the blood plasma lacks the ideal concentration of any solutes, these will move into the patient’s blood. Conversely, the dialysate fluid does not contain any waste products such as urea – so these substances in the patient’s blood move down the concentration gradient into the dialysate.

Anticoagulant
Heparin is the usual anticoagulant that is added to the patient’s blood as it enters the dialysis machine (in order to prevent the blood from clotting as it passes through the machine). Preventing the blood from clotting should, in turn, prevent any blood clots from blocking the filtration surface of the system. However, heparin is not added during the final hour of dialysis in order to enable the patient’s blood clotting activity to return to normal before he or she leaves.”

Finally, I went to the museum site itself for more information. You can find their site at https://www.nwkidney.org/about-us/dialysis-museum/. This important piece of information showed up there.

“It was 1960 when Dr. Belding Scribner and his colleagues at University of Washington developed the Scribner shunt, a device made of Teflon that could link an artery and a vein. This relatively simple device was revolutionary – it made long-term dialysis possible for the first time. Chronic kidney failure was no longer a death sentence.”

So now I know… and so do you. If I ever get out to Seattle again, this museum is on my list of places to visit.

Before I go, The American Kidney Fund asked me to let you know about two webinars this month, both on topics close to my heart… I mean my kidneys. They are Slowing down kidney disease on September 20th and Tips for talking with your doctor on Sept. 25th. Why not mark these on your calendar now while you’re thinking of it?

Until next week,

Keep living your life!

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