Dialysis has been around for just over 100 years. The first human dialysis treatment took place in 1924 in Germany, though the technology didn’t reliably save lives until the mid-1940s. From those early experiments to the machines used today, the story of dialysis is one of incremental breakthroughs, each solving a problem that had killed patients before.
The First Human Treatment in 1924
Georg Haas, an internist at University Hospital Giessen in Germany, performed the first human hemodialysis in 1924. He had practiced on animals first (he even filmed a short demonstration titled “Blood Washing of a Dog”) before moving to human patients. A surgeon assisted by creating a connection between an artery and vein in the patient’s arm so blood could flow out of the body, through a filtering device, and back in.
Over the following years, Haas treated 11 patients with kidney failure. None survived. Their conditions were too severe, sterilization methods were primitive, and the technology itself was barely functional. Still, Haas proved the core concept: you could pull waste products from a person’s blood using a membrane, then return the cleaned blood to the body.
The First Patient to Survive
The next major leap came from Willem Kolff, a Dutch physician working during World War II. Kolff built his artificial kidney from whatever he could find: cellophane sausage casing (originally made for hot dogs in Chicago) served as the filtering membrane. A Ford Model T water pump circulated the salt solution. A sewing machine motor rotated the drum that held 40 meters of blood-filled cellophane tubing. Blood moved through the system by gravity.
Between 1943 and 1945, Kolff’s team treated 16 patients with early versions of this device. Fifteen died. The sixteenth survived, but the role dialysis played in her recovery was unclear. Then on September 11, 1945, Kolff performed an 11.5-hour dialysis session on a 68-year-old woman who had fallen into a coma from kidney and liver failure. After the treatment, she woke up. She went on to live another eight years, becoming the first long-term dialysis survivor and proving the technology could genuinely save a life.
The Shunt That Made Long-Term Dialysis Possible
Even after Kolff’s success, dialysis remained a short-term rescue treatment. Each session required surgeons to cut into a patient’s blood vessels, and after a few treatments, the patient simply ran out of usable access points. Chronic kidney failure patients, who needed dialysis repeatedly for the rest of their lives, had no real option.
That changed in 1960 when Belding Scribner, a physician in Seattle, watched a young man recover briefly after dialysis only to die weeks later when no further treatments were possible. Scribner and his colleague Wayne Quinton designed a U-shaped tube made of Teflon that could be permanently implanted between an artery and a vein. This “Scribner shunt” stayed in the body between sessions, and clinicians could open and close it each time without surgery. Teflon’s non-stick surface prevented blood clots from forming inside the tube, which had been a fatal problem with earlier materials. For the first time, patients with permanent kidney failure could receive dialysis indefinitely.
Peritoneal Dialysis Emerges
Not all dialysis involves filtering blood through a machine. Peritoneal dialysis uses the lining of the abdomen as a natural filter. A cleansing solution is pumped into the abdominal cavity, waste products pass through the peritoneal membrane into the fluid, and the fluid is then drained out.
This approach developed on a parallel track. By the 1950s, intermittent peritoneal dialysis was an established treatment for acute kidney failure, using commercially available polyethylene and nylon catheters. The real turning point for chronic use came in 1968, when Henry Tenckhoff designed a silicone rubber catheter with polyester cuffs that could remain in the body long-term. A single-cuff version worked for short-term acute cases, while a two-cuff version allowed patients with chronic kidney failure to use peritoneal dialysis as ongoing treatment. This eventually opened the door to home-based peritoneal dialysis programs.
Dialysis Moves Into the Home
Home hemodialysis first developed in the early 1960s, shortly after the Scribner shunt made repeat treatments feasible. The idea was practical: if patients could learn to operate the equipment themselves, they wouldn’t need to travel to a hospital several times a week. Early home programs trained patients and family members to manage the entire process. Home dialysis peaked in popularity during the 1970s before declining as in-center dialysis clinics expanded. It has seen a modest revival in recent years as equipment has become smaller and more user-friendly.
How the U.S. Government Stepped In
By the early 1970s, dialysis was effective but extraordinarily expensive. Most patients simply couldn’t afford it, and insurance coverage was inconsistent. In a now-famous 1971 demonstration, a patient was dialyzed in front of the U.S. Congress to illustrate what was at stake.
In October 1972, Congress passed the Social Security Amendments, which created the National End-Stage Renal Disease Program. This law extended Medicare benefits to cover dialysis and kidney transplantation for nearly all Americans with permanent kidney failure, regardless of age. It remains one of the only conditions that qualifies a person for Medicare coverage on its own. The program transformed dialysis from a treatment rationed to a lucky few into a widely accessible, publicly funded therapy.
Where Dialysis Stands Today
In 2023, the total number of Americans living with kidney failure reached an all-time high of 831,192, a figure that includes both dialysis patients and those living with a transplanted kidney. That number rose 2% in a single year after three years of relative stability. Globally, millions more depend on some form of dialysis to stay alive.
The machines themselves bear little resemblance to Kolff’s sausage-casing drum. Modern hemodialysis units are computerized, precisely regulated, and far safer. Sessions typically run three to four hours, three times per week for in-center patients. Peritoneal dialysis can be done overnight while sleeping. Yet despite a century of refinement, the five-year survival rate for dialysis patients is only about 40%. The treatment replaces some of what healthy kidneys do, but not all of it. A kidney transplant remains the closest thing to a cure, and dialysis serves as the bridge, sometimes for years, while patients wait.
From a sewing machine motor and hot dog casing in occupied Holland to computerized clinics treating hundreds of thousands, dialysis has come a long way in its first hundred years. But its origin story is a reminder that the technology people now take for granted was built on decades of failure, improvisation, and patients who didn’t survive long enough to see the next breakthrough.