Early Dialysate Delivery Systems in Japan

Abstract

In 1952, the Kolff–Brigham artificial kidney manufactured in the USA was used by the US Army in the 11th Field Hospital under unit chief Paul Teschan, during the Korean War. Patients suffering from massive muscle injury due to crush syndrome were effectively saved from acute kidney failure by this artificial kidney. Prior to that, the majority of doctors worldwide did not realize the therapeutic effects of the artificial kidney. This was also true in Japan. However, immediately after being informed by the headquarters of General MacArthur’s army about the successful treatment of acute renal failure in 1952, Seiji Kimoto of the University of Tokyo initiated the artificial kidney project. Kishuo Shibusawa of the Kimoto Department of Surgery, University of Tokyo School of Medicine, requested that a custom-made Skeggs type artificial kidney be fabricated by Risaburo Aoki of Senko Medical Instrument Mfg. Co., Ltd., Tokyo, Japan. It took two years to complete this custom-made artificial kidney. The early history of dialysis in Japan is shown in Table 1. Utilizing such an artificial kidney, Shibusawa initiated clinical studies in 1954 at the University of Tokyo. Later, he moved to the University of Gunma School of Medicine as chairman and professor of surgery, and he actively treated the acute renal failure patients there. His custom-made devices were modified Skeggs–Leonards plate type artificial kidneys. The cellophane membrane used was manufactured by the German company Enka GmbH in WuppertalBarmen, Germany. Dialysate flow was maintained at 250 ± 50 mL/min. They treated 27 acute renal failure patients with 65 dialysis sessions. Out of the 27 Table 1. Early Development of the Artificial Kidney in Japan