-
The Concept of Peritoneal Dialysis
Christopher Warrick first established the concept of Peritoneal Dialysis from a novel treatment. He was able to treat a 50 year old lady who was suffering from severe ascites through the instillation of Bristol water and claret wine into her peritoneum via a leather pipe. Despite that the patient. reacted agressively towards the therapy, she successfully recovered. After which, Reverend Stephen Hales wrote about the modification of the treatment procedure -
Period: to
History of Peritoneal Dialysis
-
The First Experiment
G Wegner performed the first animal experiment to monitor the metabolic transport processes occurring through peritoneum by injecting various substances into the rabbit.From the experiment, he was able to deduce that the concentrated sugar soluton would increase fluid in the abdominal. Thus, with such discovery, Wegner established the basis of using peritoneum to remove fluid. -
First Patient Treated With Peritoneal Dialysis
George Ganter had conducted animal experiement by ligating the ureters of rabbits and guinea pig, and injected saline solution into the peritoneal cavity. Using the same approach, he was able to treat the first patient who suffers from ureteral obstruction due to uterine carcinoma via peritoneal dialysis -
First Patient Safely Treated With Continued Dialysis
The Wisconsin General Hospital continuously used peritoneal dialysis on patient with urinary obstructive disease until the obstruction subsided. Hence, they were able to deduce that patients could be safely treated by continuous peritoneal dialysis. -
Successful Recovery Of Patient Suffering From Acute Renal Failure
Arnold Seligman, Jacob Fine, and Howard Frank had created a system to improvise upon the machine in which it allows optimal flow rates and alteration of solution to suit the patients’ needs. The system successfully treated a patient who was suffering from acute renal failure. -
More Patients Using Peritoneal Dialsys
More than 100 patients were treated by the peritoneal dialysis in which two-third of these patients suffered from acute renal failure. -
The Intermittent Peritoneal Dialysis
Ruben and Doolan introduced the intermittent peritoneal dialysis in which new catheter was inserted whenever dialysis is needed and it was the first time patient can be maintained on the peritoneal dialysis in the long run -
New System To Prevent Infection
1950-1959:
Morton Maxwell designed a simple system to prevent infection by using as little connection and disconnection as possible. The machine was manufactured using a glass container, plastic tubing set and a polyethylene multi-hole catheter. The design of the machine allows the practice to instill 2 litres of solution into the peritoneal and let it settle for 30 minutes before draining the fluid. This simple technique will thus continue until the patient's biochemistry was normal. -
The Automated Dialysis Machine
Boen developed the automated dialysis device that allows patients to perform peritoneal dialysis at home. The “repeated puncture” method was also introduced which requires physicians to surgically place a 14F trocar in the patient’s abdomen and it will later be removed by the patient’s helper after the dialysis. -
Introduction of Stylet Catheter (Trocath)
Weston and Roberts improvised the straight nylon catheter also known as the "acute" dialysis catheter by adding the metal stylet (Trocath) into the catheter to punture the abdominal wall and peritoneum -
Tenckhoff's silicone catheter
Henry Tenckhoff modified and improved the catheter by introducing 2 types of silicone catheter, straight and coiled. He also added 2 Dacron cuffs around tha catheter, one placed within or just outside the abdominal musculature and the other is located below the skin surface. Thus, with these advances, there was renewd interest in peritoneal dialysis. -
Continuous Ambulatory Peritoneal Dialysis (CAPD)
The Continuous Ambulatory Peritoneal Dialysis (CAPD) was used by Robert Popovich and Jack Moncrief, a simple dialysis technique was introduced which requires surgical insertion of CAPD catheter on the abdomen. Despite that CAPD was not suitable as a long-term treatment, it has benefits that include reduction of dietary and fluid restriction, shunt problem and provide increased mobility and independence. -
The Continuous Cycling Peritoneal Dialysis (CCPD)
The Continuous Cycling Peritoneal Dialysis (CCPD) was introduced in which it may be done at night while the patient is sleeping. The device is specifically useful for working patients as it is convenient and it reduces the chances of getting infections.
