The first successful kidney dialysis treatment for chronic renal failure was performed in 1945. This treatment used an early version of a dialysis machine to remove waste and excess fluid from the blood of a patient whose kidneys had failed. Over the following decades, major advances were made in dialysis equipment and techniques.
In 1960, the first portable kidney dialysis equipment allowed patients to receive treatment at home instead of only in clinical settings. This helped transition dialysis from an emergency treatment to a viable therapy that could help sustain patients long-term. Through the 1960s and 70s, new membranes and equipment designs increased treatment efficiency and made dialysis available to more patients worldwide.
Modern Hemodialysis Machines
Today's standard hemodialysis machines are highly sophisticated compared to the early models. They are able to precisely control the filtering process and monitor treatment parameters. Modern machines use advanced membranous filters and double-pump blood tubing sets to draw blood from the patient, pass it through the dialyzer to remove toxins, and return cleaned blood back to the circulation.
Machines also continuously monitor blood pressure and flow rates during treatment. Alarms alert clinicians to any parameter shifts that could impact treatment safety or efficacy. Digital screens display ongoing treatment data that helps clinicians optimize therapy. Many machines can be programmed with individual treatment profiles for each patient.
New filters made from various synthetic materials have refined pore sizes and geometries to maximize clearance of uremic wastes while minimizing loss of proteins and blood cells. Filters are designed for single-use and sterility to prevent infection risks. Such advances optimized treatment times, which have decreased from the original 8+ hour sessions. Most patients today receive 3-4 hour treatments, three times weekly.
Peritoneal Dialysis Systems
An alternative form of renal replacement therapy is peritoneal dialysis (PD). PD uses the patient's peritoneal membrane in the abdominal cavity as a semi-permeable filter instead of an external dialyzer. There are two primary types of PD - continuous ambulatory PD (CAPD) and automated PD (APD).
CAPD functions without a machine and relies on manual exchanges of dialysate fluid into and out of the abdomen. APD uses a programmed cycler machine at night that automatically infuses and drains dialysate during sleep. Both PD systems require permanently implanted catheters and frequent exchanges of dialysate solution bags.
Recent PD machines have gotten smaller and more portable while also gaining advanced features compared to earlier models. Systems now offer customizable, automated treatment profiles at night while allowing freedom during the day without being connected to a machine. Alarms and safety stops protect patients from problems like line disconnect or over/underfilling the peritoneum.
Cutting-Edge Developments in Kidney Dialysis Equipment
Research continues aimed at developing “artificial kidneys” that could potentially replace dialysis treatments long-term. Some exciting new areas of advancement include:
- Implantable Bioartificial Kidneys: Miniature devices are being engineered that could be surgically implanted and filter blood like natural kidneys. Challenges remain in developing biocompatible membranes and ensuring long-term functions.
- Wearable Artificial Kidneys: Portable externally worn devices are in early testing. One prototype filters blood using hollow fiber membranes and a rotating pump/cartridge to support patients for several days between treatments.
- Home Hemodialysis Systems: Simple systems are in development meant for frequent/daily home use versus just nocturnal PD. Easier to learn systems may encourage more widespread adoption of home-based therapies.
- Sorbent Dialysis: New types of membranes are being tested that could remove more toxins without fluid removal, making treatment potentially faster, easier on patients and more portable outside clinics.
While still in the research phase, these cutting-edge developments offer hope that dialysis may someday be transformed from a challenging lifelong therapy into a near-normal kidney replacement option through advances in equipment and biomedical engineering. Until then, modern kidney dialysis equipment remain lifesaving technology for managing end stage renal disease.
