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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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Obstetric renal failure
Alarming emergency and important public health marker Methodist Hospital, Dallas, 1966 (credit at foot of post) In the early days of dialysis obstetric renal failure was a major part of the work of a renal unit. Acute renal failure was estimated to occur in 1 in 1400 to 1 in 5000 pregnancies in the UK…
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Twins in transplantation
Groundbreaking – and lucky to have one John Merrill shows the Herrick twins an early dialysis machine On December 23rd 1954, 24 year-old Richard Herrick became the first successful kidney transplant recipient in Boston, Massachusetts. He was lucky both to be in Boston, and to have an identical twin brother Ronald who was prepared to…
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Diets for chronic uraemia
1949-1993: Addis to Giovannetti It didn’t work for her: a 46 year old female patient who stopped her diet. Note that it was lowering urea but not creatinine. From Shaw et al 1965, by kind permission of OUP. Low protein diets were shown to prolong the life of uraemic rats in experiments in the 1930s,…
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The Korean War 1950-3: acute dialysis finds its place
War medicine tests science and dialysis In June 1950, North Korea invaded South Korea. After a rapid advance, their army was repulsed by American and Commonwealth reinforcements, but in November China joined the war and the battle lines moved back and forth until settling around the 38th parallel marking the border. Fighting continued until an…
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Dropsy, nephrosis, nephrotic syndrome
The first effective treatment for a kidney disease, 1950. Dropsy is an ancient word (first recorded about 1290 AD) meaning oedema. Generalised oedema can be caused by heart or liver or kidney disease, or by malnutrition. In all of these it was a pretty bad sign in ancient medicine as it meant that the patient…
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The unsung story of early peritoneal dialysis
The first successful mode of dialysis for acute renal failure and still not replaced The beginnings of haemodialysis have been described many times, but the first successful peritoneal dialysis probably antedated the first successful haemodialysis by 7 years. Peritoneal dialysis was undertaken alongside haemodialysis in most renal units from the early 1960s, but also in…
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Haemodialysis was first used successfully in 1945
Willem (‘Pim’) Kolff’s remarkable achievement Kolff is famously the man who first put the developing theory of therapeutic dialysis into successful practice in the most unlikely circumstances, in Kampen in the occupied Netherlands during World War 2. Influenced by a patient he had seen die in 1938, and in a remote hospital to avoid the…
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Dialysis in the UK in 1959
50 years ago dialysis suddenly caught on in the UK In 1958 there were only 3 renal units operating in the UK, at Leeds, Hammersmith, and RAF Halton. The Leeds unit had been the first, using a modified version of the original Kolff dialysis machine, but the other two units had newer technology made by…