The true history of home haemodialysis

Sir,

Allow me to comment on certain inaccuracies in the historical introduction to the otherwise excellent article of Saner et al. [1] on the outcome of home haemodialysis patients in Switzerland. Precedent claims are rarely correct and certainly there is not a shred of evidence to support the claim by Nosé [2,3] that he performed home haemodialysis in Japan in 1961. The disputed claim was extensively discussed in correspondence between myself and Nosé and has been published in ASAIO Journal [4]. In addition, Ota does not mention Nosé's claim in his history of dialysis in Japan [5] and in a personal communication he states that ‘Nosé's claim lacks scientific proof’.

The correct history of the origins of home haemodialysis is as follows:

  1. Kirby stated in his Presidential Address to ASAIO in 1961, ‘Perhaps what we need is a home dialysis unit to be placed by the patient's bedside, so that he can plug himself in for an 8 h period once or twice a week’ [6].
  2. Independently, we published the following statement in the British Medical Journal in 1963: ‘The possibility of electronic monitoring replacing nursing monitoring must be considered. If this could be achieved the ultimate aim of home dialysis could result in the treatment of larger numbers of patients at present dying with terminal renal failure. ...’ [7].
  3. Three groups (Boston, Seattle and London) working independently, having commenced home haemodialysis in 1964, reported their experience with home haemodialysis in a meeting in Seattle in December 1964 [8].
  4. The first report of overnight unattended home haemodialysis was presented by Baillod et al. [9] at the EDTA meeting in Newcastle, UK, in 1965.
  5. The first patient placed in the home in Switzerland was referred to me by Reubi in 1965. As he was not entitled to Health Service Treatment we trained him in the home of another patient whose home was close to the Lawn Road Branch of the Royal Free Hospital in Hampstead. On returning to Lauterbrunnen in Canton Berne, he climbed the Mönch mountain (Figure 1).



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Fig. 1. Home haemodialysis: Patient WS 48 years old, climbing Mönch, Bernese Oberland, 1966. Hct 48% without exogenous EPO or blood transfusion.

 
Full details of the early history of home haemodialysis including several video clips can be found at the following internet site: www.mybesthealth.com/shaldon (accessed February 25, 2005). The site is best viewed with a broadband connection.

Conflict of interest statement. None declared.

Stanley Shaldon

25 Le Michelangelo 7 Avenue des Papalins Monaco 98000 Email: stanley.shaldon{at}libello.com

References

  1. Saner E, Nitsch D, Descoeudres, Frey FJ, Uehlinger DE. Outcome of home haemodialysis patients: a case-cohort study. Nephrol Dial Transplant 2005; 20: 604–610[Abstract/Free Full Text]
  2. Nosé Y. The disposable frame coil dialyser utilising a domestic electric washing machine as a portable type artificial kidney 1961. Downloaded from http://www.lib.hokudai.ac.jp/j_guide/lib1j.html. Accessed February 25, 2005
  3. Nosé Y. Home hemodialysis: A crazy idea in 1963: A memoir. ASAIO J 2000; 46: 13–17[CrossRef][ISI][Medline]
  4. Shaldon S. The truth about home hemodialysis. ASAIO J 2002; 48: 577–578[Medline]
  5. Ota K. History of Dialysis in Japan. In Blood Access, 1st Edn. Publisher Nankoudou, Tokyo: 1982; pp. 1–36
  6. Kirby C. Presidential address. Transactions ASAIO 1961; 7: 153–155
  7. Rae AI, Rosen SM, Silva H, Oakley J, Shaldon S. Refrigerated femoral venous–venous haemodialysis with coil preservation for the rehabilitation of terminal uraemic patients. Br Med J 1963; 1: 1716–1718
  8. Shaldon S. Experience to date with home hemodialysis. Proceedings of the Working Conference on Chronic Dialysis, Seattle, WA. University of Washington Press, Seattle: 1964; 66
  9. Baillod R, Comty C, Shaldon S. Over-night unattended haemodialysis in the home. Proc EDTA 1965; 2: 99–109




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