ABSTRACT

From the beginning, the full potential of hemodialysis for the long-term treatment of patients with chronic renal failure was limited by the lack of a means for repeated access to the vascular system. At the outset, it was necessary for repeated cutdowns to be made on an artery and vein for each dialysis, following which the vessels were ligated. e duration of a course of dialysis was, therefore, limited to the treatment of acute renal failure. W. J. Kol, the designer of the rst practical dialysis machine, observed in 1944 that ‘when a preparation of the arteries was necessary (all veins being ruined) very persistent hemorrhages arose from the subcutaneous tissue owing to the heparin…. Aer the 12th dialysis became a failure, the artery being damaged, the urea percentage of the blood rapidly rose to 640 mg% whereupon death followed’.1