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Chronic Dialysis and Dialysis Doctors in the United States: A Nephrologist‐Historian's Perspective
Author(s) -
Peitzman Steven J.
Publication year - 2001
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1046/j.1525-139x.2001.00053.x
Subject(s) - medicine , nephrology , dialysis , intensive care medicine , specialty , kidney disease , hemodialysis , family medicine
In an earlier article in Seminars in Dialysis (9:276–281, 1996), the author described the invention of clinical hemodialysis for acute renal failure and its initially equivocal reception by the emerging specialty of nephrology in the United States. A similar story of blunted enthusiasm played out following the invention of the Quinton–Scribner shunt (whose idea “came in the night”), which allowed maintenance treatment for chronic renal failure. Few centers at first could match Belding Scribner's early successes, and some physiology‐oriented university nephrologists envisioned how routine dialysis might swamp other activities. Nonetheless, increasingly complex and successful inventions appeared and prevailed: the chronic dialysis unit, the national dialysis chain. A unique federal entitlement program fostered the spread of maintenance dialysis, but so did the emergence of disposable off‐the‐shelf supplies and many new nephrologists trained in academia but seeking positions in practice. Indeed, the spread of end‐stage renal disease (ESRD) care transformed American nephrology. The essay concludes by considering what nephrologists of the ESRD era share with their patients.