Dead People

Hmmm, maybe that title should read “Famous People Who Died from Kidney Disease.” Let’s go back a bit to see what I’m talking about. By now you know my youngest married on the 6th of this month. Thank you to everyone who sent their best wishes. She and her husband did a wonderful job of creating the wedding they wanted, just as the new Mr. & Mrs. Nielson are doing a terrific job of creating the life they want together.

Of course, her sister came out from New York to join the festivities. As usual, she stayed with Bear and me. That gave us plenty of time to gab between the pre-wedding potluck at my house and all the preparations for the wedding. At one point, I casually mentioned to her that Jean Harlow died of kidney disease. That fascinated Nima for some reason. As I explained the how and why, she asked me why I hadn’t yet written a blog about famous people who died from kidney disease.

At first, I thought it a bit macabre but then I rethought that. My new thinking ran along the line of, “What a perfect blog for Halloween week.” By the way, that’s my brother’s birthday and there is nothing spooky about him. Oh, our preconceptions.

Back to Jean Harlow. For those of you who don’t know, she was not only an American film actress during the 1930s, but a sex symbol as well.

This is from the official Jean Harlow website at https://www.jeanharlow.com/about/biography/

“While filming Saratoga in 1937, Jean was hospitalized with uremic poisoning and kidney failure, a result of the scarlet fever she had suffered during childhood. In the days before dialysis and kidney transplants, nothing could be done and Jean died on June 7, 1937.”

A couple of reminders:

Uremic poisoning is what we now call uremia. This type of poisoning happens when the kidneys can’t filter your blood.

Kidney failure means your kidneys don’t work anymore. One of their jobs is to filter urea from your blood so that it doesn’t build up resulting in uremia.

As for the scarlet fever, “In general, appropriately diagnosed and treated scarlet fever results in few if any long-term effects. However, if complications develop for whatever reason, problems that include kidney damage, hepatitis, vasculitis, septicemia, congestive heart failure, and even death may occur.“ (Courtesy of MedicineNet at https://www.medicinenet.com/scarlet_fever_scarlatina/article.htm)

Dialysis was invented in 1943 by Dr. Willem Kolff. It wasn’t until the 1950s before it was perfected, but for Acute Kidney Injury (AKI) only. To make matters worse, few machines were available. Dr. Belding Scribner then developed a shunt to make dialysis effective for End Stage Renal Disease patients. In other words, not only those with short term kidney injuries, but also those whose kidneys were shutting down permanently. It wasn’t until 1962 that he opened the first outpatient dialysis unit. Later on, he developed the portable dialysis machines.

Keep those years in mind. Keep in mind also that there was no dialysis or transplantation when these people died of kidney disease.

You may remember the blog I wrote about the Austrian composer Wolfgang Amadeus Mozart. He died of kidney failure back in 1792… way before dialysis or transplantation.

Transplantation? You’re right; I haven’t defined it yet. You cannot live without a functioning kidney unless you are on dialysis OR a new kidney – either from a cadaver or a life donor – is placed in your body. It is not a cure for kidney failure, but a treatment. Transplantees take anti-rejection medications for the rest of their lives.

Have you heard of Sarah Bernhardt? She was a French stage actress who died of kidney disease in 1923. She’d also been a silent screen actress, but reportedly didn’t care for film acting. Notice the year.

Emily Dickinson, the celebrated American poet died of Bright’s disease in 1886. (She was still alive during Portal of Time. I wonder if Jesse read her work?) Oh, you forgot what Bright’s disease is? No problem. New-Medical Net at https://www.news-medical.net/health/Brights-Disease-Kidney-Disease.aspx tells us it is “… a historical term that is not currently in use. It referred to a group of kidney diseases – in modern medicine, the condition is described as acute or chronic nephritis.”

It would make sense to define nephritis now. The suffix “itis” means inflammation of and “neph” refers to the kidneys. So, nephritis is an inflammation of the kidneys and can be due to a number of causes.

Let’s not forget the great Irish playwright George Bernard Shaw. He moved to London at 20 years old and became a critic and political activist as well. You’ve heard of the play ‘My Fair Lady’? It was based on his ‘Pygmalion’. He died of kidney disease just before he might have been saved… in 1950.

I think the one who surprised me the most was Buffalo Bill Cody. He was not just the leader of his wild West show, but also a bison hunter, scout (as in finding the way for wagon trains), gold rush participant, possibly a Pony Express rider, and actor. He died in 1917 of kidney failure.

Other famous people who have died of kidney disease include Art Tatum, Color Porter, Douglas MacArthur, Alex Karras, Manute Bol, Ernest Borgnine, Don DeLuise, Art Buchwald, Norman Mailer, Sandra Dee, Barry White, Erma Bombeck, Marlene Dietrich, and Laurence Olivier.

This blog is not meant to scare the wits out of you. Well, maybe it is in a way. Famous people from all walks of life – athletes, writers, actors, musicians, singers, military members, and others – have died of kidney disease. Many before the invention of dialysis and transplantation. Some of kidney disease in combination of other diseases. And some because they didn’t know they had kidney disease.

My point? If you belong to any of the high risk groups for kidney disease, get yourself tested. We’re talking simple blood and urine tests here. The high risk groups are “diabetes, hypertension and a family history of kidney disease. African Americans, Hispanics, Pacific Islanders, Native Americans and Seniors.” Thank you to the National Kidney Center at http://www.nationalkidneycenter.org/chronic-kidney-disease/risk-factors/ for this list.

Until next week,

Keep living your life!

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!