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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR Table of Contents   
Year : 1997  |  Volume : 8  |  Issue : 2  |  Page : 156-157
History of Development of Nephrology


Hemodialysis Section, King Fahd Central Hospital, P.O. Box 204, Gizan, Saudi Arabia

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How to cite this article:
Subramanian P T. History of Development of Nephrology. Saudi J Kidney Dis Transpl 1997;8:156-7

How to cite this URL:
Subramanian P T. History of Development of Nephrology. Saudi J Kidney Dis Transpl [serial online] 1997 [cited 2019 Aug 24];8:156-7. Available from: http://www.sjkdt.org/text.asp?1997/8/2/156/39392
To the Editor:

Like a rear view mirror of the car, Al­-Attar furnished the past developments concisely and clearly [1] . The following information forms a supplement to the excellent descriptions made earlier.

a) Erythropoietin in Nephrology

Nephrologists remember the 1980s, during which time the molecular cloning, production and therapeutic application of erythropoietin were all carried out successfully [2] .

b) Percutaneous Catheterization and HD

Although percutaneous transfemoral catheterization was described by Peirce in 1951 for retrograde arteriography, Shaldon adopted the technique for catheterization of the femoral veins for patients receiving hemodialysis [3] . Currently, to overcome the most common complications associated with blood contacting catheters, ion beam based technologies are used to make catheters thrombus resistant and infection resistant [4] . Attempts have been made to gain access through various other ways viz., access to inferior vena cava through internal mammary, translumbar and gonadal veins; and recently transhepatic permcath [5] for hemodialysis, when conventional access sites are exhausted.

c) Interposition Graft Fistulas

The original material for interposition graft was autogenous saphenous vein [6] , where­as now synthetic grafts using materials such as polytetrafluoroethylene (PTFE) are being used.

d) Peritoneal Dialysis [7]

The concept of peritoneum as a dialytic membrane was discovered in the late 19th century by Wagner in animals. Ganter in 1923, used peritoneal lavage in humans with renal insufficiency for the first time. By 1946, Seligman, Frank and Fine successfully used peritoneal dialysis (PD) in patients with acute renal failure. The other notable names in the history of PD were Boen and colleagues (for automated PD delivery systems-1962) Weston and Robers (for placement of nylon catheter in cases of acute PD-1965), Boen (for latex rubber catheter in chronic PD), Tenchkoff (for double cuffed silicone rubber catheter for long-term use 1968), and Diaz Buxo (for continuous cycling PD-1981).

e) Renal Transplantation

Du Voronoy of Russia (Ukraine) is credited for the first technically successful human renal transplant in April 1933 [8] .

f) Immunosuppression-Futurology

A huge array of new immunosuppressive drugs are in the wings but the majority remain at the stage of pre-clinical or early phase I human studies [8] . To improve graft survival rate, molecular typing techniques are being used. New techniques are available to modulate the immune system by gene transfection, thus producing intra-graft immunosuppression without systemic side effects [9] .

 
   References Top

1.Al-Attar B. History of development of nephrology. Saudi J Kidney Dis Transplant 1996;7:373-7.  Back to cited text no. 1    
2.Winearls CG. Historical review on the use of recombinant human erythropoietin in chronic renal failure. Nephrol Dial Trans. 1995;10(Suppl 2):3-9.  Back to cited text no. 2    
3.Arana VA, Hodson JM, Menno AD, McMahon JJ, Percutaneous femora! catheterisation in patients requiring hemodialysis. J Urol 1971; 106:492- 3.  Back to cited text no. 3    
4.Sioshansi P. New processes for surface treatment of catheters. Artif Organs 1994;I8(4):266-71.  Back to cited text no. 4    
5.Po CL, Koolpe HA, Allen S, Alvez LD, Raja RM. Transhepatic PermCath for hemodialysis. Am J Kidney Dis 1994;24:590-l.  Back to cited text no. 5    
6.May J, Tiller D, Johnson J, Stewart S, Sheil AG. Saphenous-vein arteriovenous fistula in regular dialysis treatment. N Engl J Med 1969;280:770.  Back to cited text no. 6    
7.Hollo way MS. Home peritoneal dialysis and hemodialysis. In: Gutch CF, Stoner MH, Corea Al (Edrs): Review of hemodialysis for nurses and dialysis personnel. Fifth edition, Mosby Year Book Inc. St. Louis, Missouri USA 1993;211-31.  Back to cited text no. 7    
8.Parrott NR. Transplantation: Where are we now? Int J Intensive Care 1996;3(4): 126,128-130,132,133.  Back to cited text no. 8    
9.Qin L, Chavin KD, Ding Y, et al. Multiple vectors effectively achieve gene transfer in a murine cardiac transplantation model. Immunosuppression with TGF-betal or vIL-10. Transplantation 1995;59:809-16.  Back to cited text no. 9    

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Correspondence Address:
P T Subramanian
Hemodialysis Section, King Fahd Central Hospital, P.O. Box 204, Gizan
Saudi Arabia
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PMID: 18417797

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