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We’re migrating
We are migrating from historyofnephrology.blogspot.com to this new site historyofnephrology.org. New posts are on the way too.
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Hepatitis B – epidemics to vaccination
Tragedy to biotech, 1965-76 Hepatitis B virion model. medicalgraphics.de The first cases of dialysis-associated hepatitis were reported in 1965, killing a nurse, porter, and patient, and infecting several others in Manchester. The ‘Australia antigen’ was identified in Philadelphia in the same year, and the following year associated with hepatitis. A key observation was the new…
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The invention of diuretics
Dropsy becomes treatable in the 1960s Failure of pharmacological therapies in a woman with heart failure in 1964, right on the verge of the introduction of loop diuretics. During the 1800s it became clear that dropsy (extensive oedema, ascites, pleural effusions) was not a single disease, but a late feature of failure of the heart,…
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Dialysis disequilibrium
The shock of late, rapid dialysis – Glasgow, 1962 The early rotating drum dialysers had a large surface area, and because of the difficulties of doing each dialysis, coupled with the need for one-off vascular access each time until the Scribner shunt came into use, intervention was late, and dialysis sessions were infrequent and long.…
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Insipid diabetes
A disease of 1769 becomes a treatment in 2015The Edinburgh physician William Cullen described the difference between ‘sweet’ diabetes (mellitus = honey), and rare cases where the urine tasted ‘insipid’, in 1769. There were no dipsticks then, so the basis of distinction was indeed taste. There is huge variation in how much people drink. But…
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Historyofnephrology in Nephmadness
Not sure we understand this, but we’re in it. #NephMadness Click to participate; watch 1 min explanation video 4 History contenders – we have 4 history topics in two pairs, up against each other till we end up with one to go through to compete with the others. You have to vote; then after that,…
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Hundreds of local stories in the development of dialysis
Illustrated in 1960s Augusta, Georgia An account at the coincidence of racial desegregation and the first hints of feasibility of long term dialysis and transplantation. George Van Giesen and Maytag washing machine (with permission of the author). George Van Giesen entered private practice in Augusta in 1963 from a two-year nephrology/metabolic fellowship in Dallas under…
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High blood pressure becomes treatable
The first unequivocally useful drug, 1964Robust and practical sphygmomanometers (mercury and aneroid) became available in the early 1900s, but regular recording of blood pressure did not become widely routine until the 1920s and 30s. Until then, palpating the pulse offered the only insight, except that ophthalmoscopy could show severe hypertensive retinal changes, neuro-retinitis albuminurica (Figure).…
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Renal biopsy becomes mainstream, 1954
Detail at last Ambrose Tardieu for Pierre Rayer (1840) (Wellcome Images V0009820ER) For most of the first 100 years of modern nephrology, appearance by eye at autopsy was the closest you could get to seeing the structural detail of kidney disease. But between 1830 and 1870 there were key technical improvements in the quality of…
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New ways of Treating Uraemia, 1947
Kolff reflects on four available techniques This fascinating 1947 book of just over 100 pages gives Willem ‘Pim’ Kolff’s own, fuller, more reflective account of the development, testing, and first successful use of haemodialysis. Amazingly, this was achieved while working away from academic centres in Nazi-occupied Holland. The first 10 pages summarise previous work on…
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1961: threshold of the new nephrology
A symposium in Edinburgh on 25th March 1961 was one of the first in the UK to consider the full new range of clinical nephrology. Twin coil artificial kidney (Kolff-Travenol dialysis machine) in Edinburgh Dialysis for acute renal failure (ARF, AKI)The excitement in the first session is palpable. Nobody at this meeting was negative about…
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Nephrotic syndrome starts at the glomerulus
The salamander kidney gives the final proof in 1938 A spotted salamander (Wikimedia Commons, see below) It was only in the 1930s that mainstream opinion accepted that the glomerulus was the problem in nephrotic syndrome – surprisingly late. But then it was only in 1924 that it was finally proven that the glomerulus is a…
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Bright’s disease 100y after Bright
The last decade of purely clinical observation Acute glomerulonephritis with crescent formation – Volhard and Fahr 1914(one of the last renal pathology works with artwork rather than photographs) Arthur Ellis’s 1942 articles on Bright’s Disease summarised a truly impressive 20 year systematic recording of 600 patients with kidney disease at the London Hospital, followed up…
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The glomerulus is a filter
Physiologists resolve an anatomical impasse, 1924 Illustrations of Malpighian bodies, from Bowman 1842, Philosophical Transactions 132: 57-80 (p78). Wellcome Library (M0011305) – Creative Commons licence Malpighi spots glomeruli, 1666The first microscopes emerged in the Netherlands in the 1600s, early discoveries being associated with Antonie van Leeuwenhoek in the Netherlands, Robert Hooke in England, and Marcello…
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Acute nephritis in 1875
50 years after Bright Richard Bright’s 1827 report created the discipline of nephrology and triggered an exciting period of clinical research into kidney disease. William Howship Dickinson (1832-1913) was one of these early nephrologists, employed at Great Ormond St Children’s Hospital in London. In addition to an interest in neurology he wrote a notable three-part…