535
edits
Changes
→History of Acute Kidney Injury
== History of Acute Kidney Injury ==
Some of the earliest knowledge about kidney and urinary diseases dates all the way back to 9000BC. It comes from the cradle of Western civilization, Mesopotamia, from the cuneiform clay tablets of Acadia, Assyria, and Babylon that contain references to urinary obstruction, stone, cysts, urethritis, stricture, and urethral discharge. In ancient Babylon physicians made diagnoses depending on the appearance of the urine. They treated symptoms with remedies derived from plants or minerals. Drugs were administered by blowing them through a tube into the urethra, most likely also to relieve urinary obstruction, and using alcohol as an anaesthetic. Much of the medical information generated in Mesopotamia was later transported to the Mediterranean, especially to Greece.<ref name = "Ref7"> Geller, M. J., and Cohen, S. L. Kidney and urinary tract disease in ancient Babylonia, with translations of the cuneiform sources. Kidney International 1995; 47: 1811–1815.</ref> <ref name = "Ref8"> Mujais, S. The future of the realm: medicine and divination in ancient Syro-Mesopotamia. Am J Nephrol 1999; 19: 133–139.</ref>Except for infections which cause symptoms such as pyuria, pain and fever, at the time (about 450BC), most diseases of the renal parenchyma were unknown in Greek and Roman antiquity. Treatments for uraemia included the use of hot baths, sweating therapies, bloodletting and enemas. First records of urinary diseases are found in the Hippocratic Corpus, a collection of some 60 studies that are believed to represent the work of several medical writers. How much was written by Hippocrates himself remains uncertain. Nevertheless, Hippocrates of Cos (460–377 BCE) is regarded as the father of medicine, and many of the aphorisms attributed to him refer to diseases of the kidney.<ref name = "Ref7"/> <ref name = "Ref8"/> <ref name = "Ref9">Diamandopoulos, A. A. Twelve centuries of nephrological writings in the Graeco-Roman world of the Eastern Mediterranean (from Hippocrates to Aetius Amidanus). Nephrol Dial Transplant 1999; 14[7Suppl 2]: 2–9.</ref> <ref name = "Ref10">Marandola, P., Musitelli, S., Jallous, H., Speroni, A., de Bastiani, T. The Aristotelian kidney. Am J Nephrol 1994; 14: 302–306.</ref> <ref name = "Ref11">Marketos, S. G., Eftychiadis, A. G., Diamandopoulos, A. Acute renal failure according to ancient Greek and Byzantine medical writers. J R Soc Med 1993; 86: 290–293.</ref> <ref name = "Ref12">F Reubi, [8On the history of kidney disease][9][, Schweiz Med Wochenschr 1987; 7;117(10][11][12]): 369-76</ref>
Even in the Renaissance renal diseases were still not being properly identified and oedema was generally thought to be related to liver disease. In 1827, Richard Bright provided the first, almost complete clinical description of the various forms of acute and chronic glomerulonephritis and showed that they were accompanied by macroscopic changes in the kidneys. Between 1850 and 1885, Frerichs, Klebs and Langhans described the primary glomerular lesions. Scottish chemist Thomas Graham first described dialysis in 1854. He used osmosis to separate dissolved substances and remove water through semi-permeable membranes, although he did not apply the method to medicine.[12]
The first human dialysis machine was constructed in 1943 by Dr Willem Kolff. His work to create an artificial kidney began in the late 1930s when he was working in a small ward at the University of Groningen Hospital in the Netherlands. Kolff’s machine is considered the first modern drum dialyzer. The first patient in the world to be treated by repeated haemodialysis was Clyde Shields in 1960 in Seattle. After the early successes in Seattle, haemodialysis established itself as the treatment of choice worldwide for chronic and acute kidney failure. Membranes, dialyzers and dialysis machines were continuously improved and manufactured industrially in ever-increasing numbers. A major step forward was the development of the first hollow-fibre dialyzer in 1964. This technology replaced the until-then traditional membranous tubes and flat membranes with a number of capillary-sized hollow membranes. This procedure allowed for the production of dialyzers with a surface area large enough to fulfil the demands of efficient dialysis treatment. [13][14]
