History of Dialysis and Dialysis Access

The history of dialysis began more than two centuries ago with the experiments of Thomas Graham and culminated in the creation of the hemodialysis machine by Willem Kolff. The history of vascular access was intertwined with the developments in hemodialysis technology because a reliable access was necessary to provide blood to the dialyzer. Invention of the Scribner shunt, the Shaldon catheter, and the Brescia-Cimino arterio-venous fistula provided reliable long term vascular access for the end-stage renal disease (ESRD) patient on hemodialysis. The challenges of dialysis technology and vascular access creation accompanied by the growing number of ESRD patients nudged physicians to look for other simpler forms of dialysis. Peritoneal dialysis, successfully accomplished in animals by George Ganter a century ago, became the alternative method after Henry Tenckhoff designed a catheter that could be implanted in the abdominal wall for chronic use. In its early years dialysis was funded by local grants with some assistance from the Federal government. The growing number of dialysis patients, the Gottschalk Committee report, testimonies of dialysis patients to the House Ways and Means Committee and the political efforts of George Schreiner and Belding Scribner paved the way for financial coverage of dialysis by the Federal government in 1972.