Dialysis developed for kidney failure
The first practical demonstration of this process, known as continuous dialysis of blood was by John Abel in 1914, using anaesthetised rabbits and dogs and dialysis membranes made from treated parchment. After 2-3 hours of dialysis, the animals made complete recoveries. Although the intention was to develop a way to measure the blood concentration of substances such as hormones, Abel highlighted the potential of his process as an 'artificial kidney', through which it was possible to remove toxic metabolites from the blood using membranes, and return the blood to the body.
Disturbing the flow of blood in this way can induce blood clotting, and while Abel prevented coagulation using an anticoagulant extracted from leeches, hirudin, the discovery of heparin, an anticoagulant occurring naturally in mammals, and suitable for use in humans, was a significant step.
In the meantime, improved dialysis membranes made from cellophane, and dialysis machines which required a smaller volume of blood, had been developed. These developments paved the way for the first successful treatment of a patient with acute kidney failure by Willem Kolff, in 1945.
One major drawback of kidney dialysis machines is that the patient has to remain attached to them for many hours at a time, several times a week. Experiments on guinea pigs, rabbits, dogs and monkeys from the 1920s onwards formed the basis of peritoneal dialysis. This led ultimately to the development of continuous ambulatory peritoneal dialysis (CAPD) in which waste products and water are continuously removed whilst patients carry on their normal daily lives. CAPD became freely available in the UK in 1980, giving hope to people suffering from chronic kidney failure.
- Abel J, Rowntree L, Turner B (1914) J Pharmacol Exp Ther 5, 275-316
- McBride (1980) in Clinical Dialysis, ed Nissenson, Fine & Gentile, Prentice Hall
- Boen S (1964) Peritoneal Dialysis In Clinical Medicine, C Thomas