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...everything you need to know about doing dialysis at home.
Here we present a chronological tour of dialysis from the beginning.
All photos by Jim Curtis; descriptions courtesy of Baxter.
This was the first commercially available and completely disposable dialyzer. It was introduced on October 30, 1956, by the Travenol Division of Baxter Laboratories, Inc., in Morton Grove, IL. The machine was a result of a collaboration between Dr. Willem Kolff and William B. Graham, CEO of Baxter. The coil also came with an inlet (arterial) bloodline, U200B, and an outlet (venous) bloodline, U200C. The coil and bloodlines sold for $59.00. The urea clearance was 140 mL/min. Because the priming volume was 1200 to 1400 mL, the priming volume for the patient was refrigerated between treatments.
McBride P. Genesis of the Artificial Kidney. Baxter Healthcare; 45-46.
These Kiil boards were produced in Norway under the direction of Fred Kiil, MD. Three or more of these boards were used with two sheets of membrane sandwiched between each pair of boards. The membrane was Cuprophan™. The grooves in the boards directed the blood between the layers of membrane and the dialysate outside the membrane envelope in opposite directions from one end of the boards to the other.
The priming volume was less than 300 cc. When a shunt was used, the blood could be pumped through the device with blood pressure only; no blood pump was needed. Excess fluid was removed by the use of negative pressure on the dialysate effluent line.
This type of device was used for overnight, unattended hemodialysis that was pioneered by Belding Scrbner, MD, and his group in Seattle, WA. A totally monitored dialysate system was required to automatically mix the dialysate and to control temperature and conductivity. This delivery system was developed by Albert Babb, PhD, while at the University of Washington.
Kiil F. Development of parallel-flow artificial kidney. Acta Chir Scand. 1960; Suppl 253: 142-150.
In 1964, Charles Bernard Willock’s young daughter invited a friend home. She brought along her father, Richard Drake, MD, a nephrologist, who told Willock about a patient who needed $30,000 for dialysis treatments. The patient had sold his house to pay for the life-saving therapy, but his wife left him with the money. Drake told Willock what was needed to administer the treatments, and Willock designed the machine “in about an hour,” according to an article in The Oregonian. He built the prototype out of parts in his basement, spending only $250 for new parts.
A few months later, the first machine was used on a patient at Good Samaritan Hospital. Then Drake and Willock founded the Drake Willock Co. to manufacture the machines in Milwaukie, OR. Five hundred machines were sold during their first year of operation. Eventually, they were manufacturing about 300 machines a month with international sales of more than $12 million in 1977, the year the company was sold.
Used with permission from iKidney.
This machine was developed from the prototype “Mini-1” machine designed by Albert “Les” Babb for his best friend’s daughter, Caroline Helm. It was called the Mini-1 because Dr. Babb had designed a much larger system, “The Monster”, for the University of Washington prior to this home patient version.
The Model A was built by the Milton Roy Company in St. Petersburg, Florida in 1964. It was designed to perform nocturnal home hemodialysis. It was done in a wooden veneer to have a furniture appearance for the home. It featured automatic hot water (90 degrees C) disinfection, automatic alarm checks, solid-state (diode) logic, and acoustic tile inside to reduce noise.
This instrument became the first of a series of negative pressure single patient systems culminating in the 9th generation, the Baxter Arena introduced in 2002.
Twardowski, Zbylut J., Laudatio: Albert L. Babb, Hemodialysis International, Volume 7, Number 4, 2003.
S.T. Boen, C.M. Mion, F.T. Curtis and G. Shilipetar developed an automated device to do peritoneal dialysis at home. It utilized a 40-liter bottle that was filled and sterilized at the University of Washington. The bottles were delivered to the patient’s home and returned to the hospital after use.
A cam cycler timer was used to meter the peritoneal fluid into and out of the peritoneal cavity. A heater plate heated the solution to body temperature and the effluent from the peritoneum was measured.
Fred Boen, MD, used the “repeated puncture” method for access. This required that a physician go to the patient’s home and surgically place a 14F trocar in the patient’s abdomen. The patient’s helper would be trained to remove the trocar after the peritoneal dialysis treatment.
Boen ST, Mion CM, Curtis FK, Shilipetar G. Periodic peritoneal dialysis using the repeated puncture technique and an automatic cycling machine. Trans Am Soc Artif Intern Organs. 196; 10: 408-14.
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