Dialysis :

HISTORICAL BACKGROUND

B. Shaibani MD, PhD

Azzawiyah kidney Center

2018

Proteinuria: a Bad Thing since 400 BC

HEMODIALYSIS

form

History

1854, THOMAS GRAHAM FIRST PRESENTED THE PRINCIPLES OF SOLUTE TRANSPORT ACROSS A SEMIPERMEABLE MEMBRANE

1861, THOMAS GRAHAM COINS THE WORD DIALYSIS

1913, ABEL & ROWNTREE CONSTRUCTED FIRST ARTIFICIAL KIDNEY

History

1924, THE FIRST HEMODIALYSIS IN A HUMAN BEING

BY HASS

1943, KOLFF & BERK FIRST CONSTRUCTED WORKING

DIALYZER & PRACTICAL HEMODIALYSIS MACHINE

1946, NILES ALWALL PRODUCED THE FIRST DIALYZER

1930s by Kolff,

Now , …..

The Invention of IV Fluid Therapy; 1932

Kolff & Berk’s first artificial kidney with blood ran

around a wooden drum of aluminum slats & static open dialysate bath, 1942

History

1946, THE FIRST PATIENT TREATED SUCCESSFULLY BY

DIALYSIS

1948, THE PARALLEL PLATES DIALYZED WAS DEVELOPED,

TILL EARLY 80S WERE USED

1960, AV SHUNT AS DESCRIBED BY QUINTON & SCRIBNER

In 1945, Patient #17, Mrs. Sophie Schafstadt, a 67-year-old woman in uremic coma regained consciousness following 11hrs HD with the dialyzer & lived for another 7 years –The first patient in the world whose life was clearly saved by the artificial kidney

Korean War 1950- Acute Dialysis

1952

Pressure cooker artificial kidney ,1953

Mini II Hemodialysis Machine Mid 1960s

1984

B Braun

I knew that machine !!

The most recent I

know will

it be in Libya

before

2020!!

You know this

Dialysis in Libya Where to …!?

New

New water treatment plant

DoI need to know all of this ..?

Should

I

Insist

on

This ??

Home dialysis , private dialysis is it big deal ..? …when to be available in Libya ??

ZKC 2014

What wentwrong

Dialysis centers in Libya

Dialysis Center, 2014

Beds

Or Chairs

Access for dialysis

Scribner Developed Scribner Shunt, 1960

Teflon Silastic Dialysis Shunt

1966 YearToBe Remembered

Primary AV Fistula

Squeezing a Rubber Ball for Exercise

Do U know that

CRRT

Home Dialysis

The Birth of Home Dialysis

The Birth of Home Dialysis

Home Dialysis, 1972

Home Dialysis

1973 in Jomhuriyah hospital Benghazi1974 in University hosp. Benghazi1974 in Central hosp. Tripoli1975 in Tajoura hosp. Tripoli1978 in Hawari hosp. Benghazi

1980 in Jamil hosp.1983 in Zawia hosp.

......1988 in Zahra hosp.

In 2008 less than 50 centers and units with about 2000 patients 2018 more than 65 centers and units with more than 4200 patients

HEMODIALYSIS IN LIBYA

PERITONEAL DIALYSIS

1887

WEGNER FOUND THAT THE PERITONEAL

SURFACE AREA & THE SKIN SURFACE AREA IN

THE ADULT WERE APPROXIMATELY EQUIVALENT

Georg Ganter was the 1st to Use PD to Treat a woman with Kidney failure 1923

1938

WEAR RECORDED THE FIRST USE OF

SUCCESSFUL PD FOR TREATMENT OF ACUTE

RENAL FAILURE

1946

1948

BLOXSUM & POWELL FIRST REPORTED THE USE

OF PD TO TREAT ACUTE RENAL FAILURE IN

CHILDREN

PD was Initially Used as IPD, Continuous for 1-2 Days/wk

PD Catheters

Early 1950

POLYVINYLCHLORIDE & POLYETHYLENE

PLASTIC TUBES WERE USED

MAXWELL INTRODUCED A NYLON CATHETER

WITH SMALL PERFORATION & CURVED DISTAL

END

Early 1960

TENCKHOFF USED A PERMANENT CATHETER

MADE OF SILICONE RUBBER WITH DARCON CUFF

1961SEGAR FIRST REPORTED THE USE OF

INTERMITTENT PD IN CHILDREN WITH ARF

Automated PD Machine, 1964

Automated cyclic machines appeared in 1960s

Automate PD Cycler

Automate PD Cycler

Automated cyclic PD was the most common form of

PD used in children in 1990s

1977

THE ITALIAN Y SET CANNULAR SYSTEM WAS

INTRODUCED

IT CONNECTS TWO BAGS, ONE WITH FLUID & THE

OTHER FOR DRAINAGE BY GRAVITY

1988*i

ABUDRAA ET AL FIRST USED ACUTE PD FOR

PEDIATRIC PATIENTS WITH ACUTE RENAL

FAILURE IN TRIPOLI

1989

ALFITURI N. ET AL FIRST USED ACUTE PD FOR

ADULTS PATIENTS WITH ACUTE RENAL FAILURE

IN ZAHRA

Feb. 2005

CAPD STARTED IN BENGHAZI, SABRATHA & ALSHAAT

1977

OREOPOCLEN MODIFIED CAPD

HE USED POLYVINYLCHLORIDE BAGS WHICH

CARRIED UNDER-CLOTHS & INCREASED INDWELLING

TIME TO 4 HOURS THEN DRAINAGE INTO SAME BAG

BY GRAVITY

PD is more Flexible

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