Motivational

Timeline of kidney disease and its treatments

Today people suffering from chronic kidney disease (CKD) are treated with dialysis and kidney transplant. These treatments are fairly recent developments. The timeline below shows how far we’ve come, mostly in the last 100 years.

100 AD

History tells us that the first “dialysis” took place in the Roman baths. People suffering from a build-up of urea in their systems soaked in the baths to “sweat out” the toxins.

200 AD

Famous Chinese surgeon Hua-To reportedly replaced diseased organs with healthy ones. This is believed to be the first known reference to the concept of organ transplantation for therapeutic purposes. Unfortunately, his work was not documented so future generations were not able to learn from his experiences.

1500s

The first documented case of what was later known as polycystic kidney disease (PKD) occurred in Stefan Bathory, King of Poland (1533-1588).

1600s

1668

Job Van Meeneren of Holland documented the first successful bone graft when a human cranium is mended with bone from a dog’s skull. This opened the door for tissue transplant.

1700s

Many people suffering from kidney diseases went undiagnosed. Sometimes they died of urea poisoning, or “dropsy.”

1800s

Dr. Richard Bright extensively researched kidney disease, along with diseases of the heart, liver, pancreas and pulmonary system. He is known as the father of nephrology. A variety of kidney disorders having high concentrations of protein in the urine, including polycystic kidney disease (PKD), became known as Bright’s Disease.

1861

Thomas Graham described the process of dialysis.

1869

Swiss surgeon Jacques Louis Reverdin performed the first documented human tissue grafting.

1900s

1906

Dr. Edward Zirm performed the first corneal transplant, opening the door to other types of transplantation.

1912

French surgeon Alexis Carrel developed methods of joining blood vessels, making transplantation possible. He also developed fluids and a way of circulating them in order to keep transplanted tissues alive outside the body.

1913

John Abel developed an artificial kidney for dialysis with animals. However, the substance removed was salicylic acid, not urea. And Abel used hirudin (crushed leech heads) to prevent blood clotting, a substance with negative side effects.

1918

The first blood transfusion was performed.

1928

The anticoagulant hirudin was replaced by heparin, which is still in use today.

1943

Dr. Willem Kolff created a crude kidney machine. Kolff is known today as the father of dialysis.

1949

The US Navy established the first US Tissue Bank in Bethesda, Maryland.

1954

Dr. Joseph E. Murray completed the first successful living-related kidney transplant at Brigham & Women’s Hospital in Boston.

1962

Drs. Joseph Murray and David Hume performed the first successful kidney transplant from a cadaver.

1962

Dr. Belding Scribner developed the Scribner Shunt, which allowed improved access to the circulatory system.

1964

Home dialysis was introduced.

1966

The first simultaneous pancreas/kidney transplant by Drs. Richard Lillehei and William Kelly took place at the University of Minnesota, Minneapolis.

1968

Brain death criteria were created. This changed how death was determined, which affected organ donation and transplantation.

1968

The Uniform Anatomical Gift Act became law, allowing organs to be donated to others.

1972

The Uniform Organ Donor Card became a legal document in all 50 states.

The End Stage Renal Disease Act opened the door for Medicare coverage of kidney transplants and for hemodialysis.

1975

Americans watched a live kidney transplant on TV, thanks to the Today Show. The show prompted 20,000 people to contact NBC and offer their kidneys for transplant.

1976

The American Association of Tissue Banks was established.

1978

The drug cyclosporine was introduced. This immunosuppressant increased the success rate of transplants by helping to prevent rejection of donated organs. It is still used today.

1984

The National Organ Transplant Act established a national system for matching organ donors with recipients.

1987

President Reagan signed into law the Consolidated Omnibus Budget Reconciliation Act (COBRA). Hospitals in all 50 states were now required by law to ask relatives of brain-dead patients about organ donation.

1988

The organ preservation solution ViaSpan®, also called UW solution, was approved by the FDA. It became the industry standard throughout the US.

1989

Clinical investigators began using the experimental drug FK 506 with kidney, liver, heart and lung recipients. Although it seemed promising, more research was necessary to measure its safety and effectiveness.

1990

Dr. Joseph Murray, who performed the first kidney transplant, was awarded the Nobel Prize for Medicine.

1993

The FDA began regulating US tissue banks.

1994

The FDA approved Prograf (formerly known as FK506). The new medication significantly lessened the chances of a transplanted organ being rejected.

21st century

Research suggests that gene mutation may contribute to chronic kidney disease.

New dialysis treatment strategies are being developed. Dialysis experts are looking at the potential of intensified dialysis regimens. Trials are now underway to determine if either short daily dialysis or slow nighttime dialysis is a viable alternative for patients. These approaches are modifications of Willem Kolff’s original concept of improving the effectiveness of dialysis treatment.

Breakthroughs in kidney transplantation continue to be made. In February 2004, surgeons at The Johns Hopkins Comprehensive Transplant Center performed what is thought to be the world’s first “triple swap” kidney transplantation using a new technique called plasmapheresis. Plasmapheresis removes harmful antibodies that can create incompatibilities between donors and recipients. In regard to the procedure, Robert A. Montgomery, M.D., Ph.D., lead surgeon on the case and director of the incompatible kidney transplant programs (InKTP) at Johns Hopkins, stated, “We are trying to start a revolution here. By combining kidney exchanges with plasmapheresis, virtually any incompatible donor and recipient now have the opportunity to give and receive a kidney.”