March 16, 2011

A brief word before we get to the usual kidney stuff…this past week we saw the devastation that the earthquake and tsunami caused in Japan.  Our thoughts and prayers go out to the Japanese living through that destruction, and to all the Japanese around the world trying to contact their families in Japan.  If you would like to consider helping, please visit www.redcross.org .

Dialysis.  Just the very word conjures up the most unpleasant of thoughts.  Up until this point, I have been able to avoid dialysis, which has been a goal of mine and Dr. Hoenig – be able to get a transplant before needing dialysis. 

Even with a successful transplant, there is still the possibility of needing dialysis after the surgery if the new kidney does not start working right away.  Given that, I thought I should see what dialysis was all about.

In order to fully understand and appreciate what dialysis is, we need to go back and look at where it all started, and davita.com gives a great snapshot of dialysis’ very beginnings:

“Dr. Willem Kolff is considered the father of dialysis. This young Dutch physician constructed the first dialyzer (artificial kidney) in 1943.

The road to Kolff’s creation of an artificial kidney began in the late 1930s when he was working in a small ward at the University of Groningen Hospital in the Netherlands. There, Kolff watched helplessly as a young man died slowly of kidney failure. Kolff decided to find a way to make a machine that would do the work of the kidneys. The young doctor searched the university library for information on removing toxins from blood and stumbled across an article about hemodialysis with animals published in 1913 by John Abel, a renowned pharmacologist at Johns Hopkins University. Abel’s writing inspired Kolff, and he became committed to the development of an artificial kidney.

At about the same time that Kolff began his research, World War II erupted. Once the Nazis overtook the Netherlands, Kolff was sent to work in a remote Dutch hospital.

Despite challenging conditions, the young physician pressed on. Although materials were scarce, Kolff possessed the resourceful spirit of the true inventor and improvised, using sausage skins, orange juice cans, a washing machine and other common items to make a device that could clear the blood of toxins. Amazingly, he carried on his experiment under Nazi scrutiny, risking his own life by forging documents so that he could continue his work. Kolff was able to get his wife and colleagues to help, even though it meant they too were putting themselves in danger.

In 1943, Kolff’s invention, although crude, was completed. During the course of the next two years, he treated 16 patients with acute kidney failure but had little success. All that changed in 1945, when a 67-year-old woman in uremic coma regained consciousness after 11 hours of hemodialysis with Kolff’s dialyzer. Her first words? “I’m going to divorce my husband!” Thanks to Kolff, she did in fact follow through on her plan and lived seven more years before dying of another ailment.”

Today’s dialysis treatment still involves long hours of your blood being cleaned.  The actually machine may have been updated since the 1940’s, but time spent on the machine is long – 4 to 5 hours per day three or four, up to seven days per week.

For those of you currently on dialysis, or have had experience on it, I tip my hat to you.  It cannot be pleasant. 

As for me, I am currently at 16% kidney function, more kidney function loss since last month.  So it may not be long before dialysis is a consideration for me.