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The Stud of its Background

The medical intervention called, Hemodialysis, is one of the major trends of innovation in the twenty first century of urological perspective. Most importantly, the concept of Hemodialysis is the incorporation of an artificial filter for the blood; hence, the term, “hemo”, which means blood, has been coined. There various reasons for utilizing this procedure, and the most common of all is for cases of kidney failure, which renders the inability of the organ to filter the toxins from the blood.

Hemodialysis is beneficial in a sense that it removes the toxic substances, such as urea, excess fluid and potassium, from the blood, especially if the kidneys are impaired or non-functional anymore. The introduction of this system has able to extend the lives of those patients suffering mostly from kidney problems. Currently, the hemodialysis users in United States have reached the statistics of more than 250,000 for chronic hemodialysis treatments under more than 4,000 hemodialysis centers, which sums to 91% of the total population of end-stage renal disease patients (Mayhall, 2004 p. 1139).

With the increasing population utilizing the said treatment, the utilization of this medical procedure has gone to the extent of popularity and need. Hence, it is important to consider the historical foundation of this medical procedure in order to grasp the idea behind its discovery. Within this study, the discussion considers the historical evolution present in hemodialysis. The discussion tackles the process of discovery and the people responsible for its creation. Furthermore, the study considers the different problems and obstacles that have been encountered during the making of this system.

Discussion Early History Overview of Hemodialysis One of the most prominent persons behind the discovery of dialysis treatment is Thomas Graham of Glasgow. Out of the prominent persons that have contributed to the knowledge body and principles of dialysis, it is Thomas Glasgow (1854) idea of solute transport towards a semipermeable membrane that gave the basis for the conceptualization of dialysis. Thomas Graham, who is a Professor of Chemistry at Anderson’s University in Glasgow, is the one responsible for coining the term dialysis in 1861.

From one of his experiments with a vegetable parchment coated with albumin, he noticed some specimens of crystalloids that are able to diffuse through the semipermeable layers of the parchment; hence, giving the idea of dialysis. Graham utilized this method under the principle of diffusion and his first success on his dialysis experimentation is the extraction of urea from urine. The idea of Graham has been further developed by the groups of Abel, Rowntree, Turner and colleague, and through them, an introduction of the first artificial kidney under the principle of dialysis has been introduced in 1913.

Their artificial kidney is somehow the simplified version of the current dialysis with primitive and exotic materials used, such as the hirudin extract from leeches of Parisian barbers as the anticoagulant. In the methodic overview, the passage of animal blood, which is their main specimen to be filtered, from an arterial cannula through cellodin tubes that are contained in the glass jacket are their main means in imitating the nephritic filtration of the kidney. With this idea, early inventors of the 1900s thought of applying this procedure to real human body in order to compensate kidney failure cases.

Early scientists like George Haas, Willem Koff, etc. are some of the historical figures that thought of the idea of using the concept of dialysis in filtering toxic substance from kidney damage, especially for chemical emergencies within the body. George Haas performed his first successful dialysis procedure in 1924, and according to his records, he has been contemplating with this procedure with animal specimens from 1914-1915. After his service with war in 1919, he is able to continue his work within the comforts of University of Giessen wherein he has taken the opportunity to further study the Abel kidney (Nissenson and Fine, 2005 p. 5).

The conflicts that Haas have faced during his experiment were the lack of anticoagulant specimen and appropriate membrane material. He has experimented on reed tubing, sheep peritoneum, and paper membrane in order to facilitate the semipermeable membrane. Haas primary intention is to treat patients with kidney breakdown; hence, with Pregl’s research on collodion tube, Haas is able to arrive with the appropriate filter. Haas is able to perform his first dialysis on a uremic patient, which accumulated 30 minutes on his second procedure. He has facilitated the cannulation via the radial and carotid arteries, and links it with the portal vein.

The blood from these vascular sources passes through three dialyzer cells or tubes (Eknoyan, De Santo and Massry, 1994 p. 294). Haas has utilized a more refined form of Hirudin in order to suit for human use, but does not permit long-term use. In addition, Haas has managed to use a blood pump with his fourth dialysis and eventually aided the return of blood to the patient (Nissenson and Fine, 2005 p. 5). The overall procedure has become the first success of human dialysis treatment in the history of hemodialysis, and further followed by different scientists and medical specialists.

Evolution of Hemodialysis After the establishment of the founding principles of dialysis, Dr. Willem Kolff and H. Berk from Netherlands are able to enhance the dialysis process and eventually turn it into a dialysis machine. With the leading of Kolff, he is able to figure out the requirements of an artificial kidney and the method for managing a patient who is undergoing dialysis treatments. He has incorporated all this principle in his writings of 1946 entitled, New Ways of Treating Uremia, which can be considered as the first manual for hemodialysis (Nissenson and Fine, 2005 p.

7). Kolff is able to initiate the concepts and applications of the first peritoneal dialysis with the help of Berk Enamel Company in Kampen, Holland. The hemodialysis machine that Kolff and Berk developed has been sent to various parts of the world, especially after the World War II; hence, starting the hemodialysis treatment globally (Miller, 2006 p. 51). The machine is able to regain its popular name, Kolff-Brigham kidney (under W. Kolff and Peter Brent Brigham Hospital), and has been considered to be the official training apparatus for further kidney dialysis developments.

However, the dialysis of Kolff is not as clinically useful as it claims since it only filters urea and toxic components, but not excess fluid, which is most prominent to patients with end-stage kidney disease. During 1945, the Swedish scientist, Nils Alwall, is able to modify the functioning of Kolff-Brigham kidney. His aim is to incorporate the fluid filtering feature for this device in order to enhance its application and functionality (Miller, 2006 p. 51). Alwall has termed his initial device as the ultrafilter from the functionality of ultrafiltration.

The device consists 10-11m of cellophane tubing wrapped around a stationary, vertical drum made of a metal screen, which resembles to a rotating drum device standing in its end. After Alwall, various scientists have discovered different means and forms of hemodialysis enhancements. Gordon Murray is able to come up with his vertical drum type kidney dialysis machine, which is somehow similar to Alwell with few significant differences (more on structure). Leonard Skeggs and Jack Leonards have utilized rubber coating to make the seals around the edge in order to prevent blood leakage (Nissenson and Fine, 2005 p.

9). The Malinow-Korzon Dialyzers of 1948 has utilized multiple-plate structure and cellophane tubing for the purposes of ultrafiltration, which includes the Debakey-type pump that provided an alternative for determining blood values (Nissenson and Fine, 2005 p. 10). Lastly, in 1956, Kolff and Watschinger have remodified the Alwall machine with twin foil system and modifications of pressure cooker dialyzer (Inouye and Engelberg in 1952) (Miller, 2006 p. 52). All of these historical personnel have successfully managed to develop the proceedings and mechanics of hemodialysis.

The innovations made in the past have been continuously revolutionized and evolved, which now becomes the current hemodialysis machine. Globally speaking, these medical equipments have catered to various kidney failure and chemical emergency cases; hence, satisfying the main goal of the early scientists who conceptualized these device’s functionalities. Conclusion In the conclusion of the study, the historical overview suggests the impacts of Graham’s dialysis perspective on Abel, Rowntree, Turner and colleague, Haas, Kolff and various scientists who have catered developments for hemodialysis machine.

Evidently, the historical evolution of hemodialysis has always aimed in saving the lives and treating patients who have been suffering in renal failures and diseases.

References

Eknoyan, G. , De Santo , N. G. , & Massry, S. G. (1994). CHistory of Nephrology: Reports from the First International Conference on Hemodialysis. Karger Publishers. Mayhall, C. G. (2004). Hospital Epidemiology and Infection Control. Lippincott Williams & Wilkins. MIller, G. E. (2006). Artificial Organs. Morgan & Claypool Publishers. NIssenson, A. R. , & Fine, R. N. (2005). Clinical Dialysis. McGraw-Hill Professional.

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