By Kasia Michalik
When the Seattle Artificial Kidney Center (SAKC) opened its doors in January 1962, there were only seven people with what is now called end-stage renal disease (ESRD) in Seattle and 20 patients in the whole United States who had access to dialysis treatments.
The SAKC was the first out-of-hospital, nonprofit, community-supported dialysis unit in the world. It was a three-bed center that could dialyze up to nine patients two times a week using the Kiil dialyzers and tanks made by Sweden Freezer to cool the dialysate.
Fifty later and many struggles behind and more to overcome, one thing is for sure, dialysis equipment, therapy options, prescriptions and innovation have come a long way but have a long way to go in the next 50 years.
It all started with a group of people fighting for coverage. In 1971, when patient advocate, Shep Glazer, dialyzed in front of the House Ways and Means Committee it made an impact and a statement. It has allowed every single ESRD patient the ability to dialyze and not be responsible for the full costs. The following year President Nixon added kidney-disease entitlement to the Social Security Amendment of 1972 on October 30.
There are many things to look at when going back in time. Christopher Blagg, MD, FRCP, who has been in this field since it's inception, has seen it all and has worked with one of the fathers of chronic dialysis, Belding Scribner, the inventor of the Teflon shunt that made dialysis for kidney failure possible for the first time. A prime mover of the dialysis era, Scribner was Blagg's boss during those early times when everything seemed to be a struggle for quality patient care.
"Working with Dr. Scribner was incredible," Blagg said. "Seattle was the Mecca for dialysis in the 1960s because most of the developments that came, came out of Seattle, so people from all over the world came to Seattle to learn how we did dialysis. It was fun and exciting."
Clinical and political highlights came out of the 13-year struggle to help patients pay for dialysis care. Between the first patient being treated for renal failure and the United States Congress passing the legislation that created the Medicare End-Stage Renal Disease Program, many fights were fought and obstacles jumped.
"Before the legislation, I think the most important highlight was the Gottschalk Committee," Blagg said. "This was because it said that dialysis and kidney transplantation were no longer experimental therapies, that the best treatment was a kidney transplant, home dialysis came next and then center dialysis, and it suggested Medicare might be the way to pay for these treatments. This was a major step towards having patients covered through government-funded insurance."