Reference Index Page 2

History of Dialysis

    Dialysis is referred to as "selective diffusion." Diffusion is the movement of material from higher concentration to lower concentration through a given membrane. Selective diffusion is diffusion, but depending on the membrane, some material will move across the membrane and some material will not. Thomas Graham, Chairman of Chemistry at University College, London, first discovered this idea of selective diffusion. Thomas Graham's work with vegetable parchment led to his observation that it acted like a semipermeable membrane. Graham later came to call this discovery, 'dialysis'. Dialysis is a Greek word meaning "loosening from something else".

Year Discovery
1913 Abel, Rowntree, and Turner devised an apparatus for the dialysis of blood.
1943 Kolff and Berk developed the first clinically successful hemodialyzer.
1948 Skeggs-Leonards developed the parallel plate dialyzer, utilizing countercurrent flow of blood and dialyzing fluid.
1956 Travenol developed the first twin-coil disposable dialyzer unit.
1956 Hollow fiber kidneys were developed in the United States.
1956 Gambro began production of disposable parallel plate dialyzers in Europe.
1960 Kiil developed a simpler countercurrent flow method with parallel flow.

    Early stage dialyzers consisted of cellulose tubing wrapped around a small drum. The drum was then partially emersed in a bath of dialysate. The dialysate usually consisted of a saline solution only. As the drum was hand cranked, the blood was propelled through the cellulose tubing; causing a diffusion of materials from blood to dialysate and from dialysate to blood (Fig 1).

Fig 1

    As technology has advanced so has the developement of dialyzers. Dialyzers use motors to pump the blood and dialysate. Maintaining pressure upon the blood in the veins is accomplished by using microprocessors and transducers to maintain a constant pressure across the body and dialyzer. The blood and dialysate flow through high-tech plastic composite tubing. Unlike in the past, the dialysate consists of more than just saline. The dialysate can consist of sodium chloride, sodium bicarbonate or sodium acetate, calcium chloride, potassium chloride, and magnesium chloride.