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→History of Acute Kidney Injury
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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.<ref name = "Ref12"/>
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]<ref name = "Ref13">History of the kidney disease treatment, https://www.sgkpa.org.uk/main/history-of-the-kidney-disease-treatment</ref> <ref name = "Ref14">The History of Dialysis, https://www.fresenius.com/history-of-dialysis</ref>Over the years that followed, thanks to the development of appropriate industrial manufacturing technologies, it became possible to produce large numbers of disposable dialyzers at a reasonable price. Today, dialyzers are made from entirely synthetic polysulfone, a plastic that exhibits exceptionally good filtering efficiency and tolerability for patients.[14]<ref name = "Ref14"/>
== Mechanism of Acute Kidney Injury ==
