How it began
The Dutch physician Willem Kolff built the first practical artificial kidney during World War II, while working in the town of Kampen. In 1943, with the help of the engineer Hendrik Berk, he created the rotating drum kidney, which is regarded as the first working dialysis machine. By 1942 he had a first version ready for clinical experiments, and between March 1943 and July 1944 he treated 15 patients with it.
Before it existed
Before dialysis there was no treatment that could take over the work of failed kidneys. Waste products built up in the blood and the patient died. Hemodialysis as a treatment dates only from the 1940s. The Kolff rotating drum of 1943 opened a new era of treatment, in which a machine outside the body could take wastes out of the blood.
How it works
The machine used a 20-meter tube of cellophane sausage casing as its membrane, wrapped around a slatted wooden drum. An electric motor turned the drum in a tank of dialysis fluid. Blood drained from the patient into a sterile jug, was thinned with an anticoagulant and ran through the casing as the drum turned, while wastes diffused through the cellophane into the fluid. The cleaned blood collected in a second jug and was returned to the patient. A treatment took about six hours.
How it spread
The design left the Netherlands after the war. In 1948 Carl Walters and John Merrill in Boston redesigned the rotating drum as the Kolff-Brigham machine. Kolff himself later worked in Cleveland in the United States, and in 1956 the Travenol twin-coil kidney that he helped develop became the first commercially sold disposable dialyzer. Hollow-fiber dialyzers later raised the efficiency of the treatment.
Where it stands today
The rotating drum removed toxins but, because it ran at low pressure, could not also remove excess fluid; modern machines do both. Dialysis is now a standard treatment for kidney failure, and Kolff, who died in 2009, is often called the father of the artificial kidney. A replica of the original machine still exists, and the European Kidney Health Alliance records that the first version used aluminum from a downed aircraft.
