Beginnings
Prior to the 1950s failing kidney function was a guarantee of death. Healthy kidneys remove waste and excess water from the blood, but if the kidneys fail dialysis is needed to remove the excess waste. Patients could not undergo dialysis treatment indefinitely due to the glass shunts that were used in the treatment. The shunts caused damage to veins and arteries to such a degree that long term dialysis was impossible. Dialysis at that time was used only to stabilize a patient. If the kidneys did not begin to function properly the patient would eventually die of kidney failure.
A medical breakthrough
In 1960, Dr. Belding H. Scribner and his team at the University of Washington modified glass dialysis shunts by making them from Teflon.
The teflon Scribner Shunt worked by keeping the circulatory access open after dialysis treatment. Whenever necessary, the kidney dialysis machine could be attached to the tube without damaging the veins or arteries.
Award winning discovery
Dr. Scribner received the Gairdner Foundation International Award in 1969, and the Albert Lasker Award in 2002 for major contributions to medical science.
First dialysis center
With the creation of the Scribner Shunt, ongoing diaysis treatment became a reality and patients with chronic kidney disease could live with the disease. The world's first outpatient dialysis treatment center, the Seattle Artificial Kidney Center, was established in January 1962, later renamed the Northwest Kidney Center.
Limited availability: Rationing dialysis treatment
They Decide Who Lives, Who Dies
In her book, Shana Alexander chronicles the Life or Death Committee charged with deciding which patients would receive sparsely available, life saving dialysis treatment.
The 1965 NBC short documentary Who Shall Live? describes the rationing of dialysis treatment before it became widely available.
Narrated by Edwin Newman.
The Early History of Dialysis for Chronic Renal Failure in the United States: A View From Seattle
In this issue of AJKD, Dr Christopher Blagg, who was present from the early days of long-term hemodialysis in the United States, kicks off our World Kidney Forum (WKF). Dr Blagg worked closely with Dr Belding Scribner, the inventor of the Scribner-Quinton Shunt, which made long-term hemodialysis possible. Dr Blagg made major contributions in Seattle to the field of long-term dialysis over the subsequent four decades.
Dr. Mike Kelly remembers his early career in kidney care at UW Division of Nephrology
Dr. Kelly, nephrologist, medical director and board member at Northwest Kidney Centers, worked with and befriended Dr. Belding H. Scribner.
Continuing innovations in nephrology
Our work continues today with translational and basic research, clinical trials, improvements in technology and the desire to improve the lives of our patients.
We are working on a small backpack-size artificial kidney to make dialysis portable. Dr. Jonathan Himmelfarb and 30-some people are working on the Center for Dialysis Innovation’s prototype artificial kidney, a device intended to free patients from thrice-weekly, hours-long visits to dialysis centers.
Kidney on a chip has been developed for safe drug testing.
We have successfully grown mini-kidney organoids from pluripotent stem cells and used a gene-editing technique to engineer the organoids with genetic changes linked to kidney disease.
These are among the many exciting discoveries to help patients with kidney disease.