Nils Alwall

Nils Alwall (1904, Kiaby – 1986), a Swedish professor at Lund University, Sweden, was a pioneer in hemodialysis and the inventor of one of the first practical dialysis machines. Alwall pioneered the technique of ultrafiltration and introduced the principle of hemofiltration.[1][2][3] Alwall is referred to as the "father of extracorporeal blood treatment."[4]

Artificial kidney
Dialysis machine for rabbits, Nils Alwall, 1944

Willem Johan Kolff constructed the first artificial kidney, however it was not very useful clinically, because it did not allow for removal of excess fluid. Alwall modified a similar construction to the Kolff kidney by enclosing it inside a stainless steel canister. This allowed the removal of fluids, by applying a negative pressure to the outside canister. Thus making it the first truly practical device for hemodialysis. Alwall treated his first patient in acute kidney injury on the September 3, 1946, who responded well to the treatment but died of pneumonia a short while after.[5]

Alwall also was arguably the inventor of the arteriovenous shunt for dialysis. He reported this first in 1948, where he used such an arteriovenous shunt in rabbits. Subsequently, he used such shunts, made of glass, as well as his canister-enclosed dialyzer, to treat 1,500 people in kidney failure between 1946 and 1960, as reported to the First International Congress of Nephrology held in Evian in September 1960.

As of 2007, two patients for which kidney replacement therapy was initiated by Alwall in 1968 and 1971 respectively have survived for over 35 years on hemodialysis. These patients represent two of the longest known survivors on hemodialysis worldwide.[6]

Later life

Alwall was appointed to a newly created Chair of Nephrology at Lund University in 1957. Subsequently, he collaborated with Swedish businessman Holger Crafoord to found one of the key companies that would manufacture dialysis equipment in the past 40 years, Gambro, Inc.[3][7]

Nils Alwall Prize

In honor of Alwall's advancements and achievements, The Nils Alwall Prize is awarded every year for "Groundbreaking research in the field of kidney replacement therapy."[4]

References
  1. Hypertension, Dialysis & Clinical Nephrology (1997). "Nordiska Njurdagar (Nordic Nephrology Days)". Hypertension, Dialysis, and Clinical Nephrology. Retrieved October 3, 2007.
  2. Nils Alwall (1997). "Nils Alwall Lecture". Hypertension, Dialysis, and Clinical Nephrology. Retrieved October 3, 2007.
  3. Arvid Carlsson (2000). "Arvid Carlsson, The Nobel Prize in Physiology or Medicine 2000". Nobel Foundation. Retrieved October 3, 2007.
  4. BIOPRO Baden-Württemberg (2006). "Nils Alwall Prize 2006 awarded to scientist at the Medical Hospital in Heidelberg". The Biotech/Life Sciences Portal. Archived from the original on July 18, 2011. Retrieved October 3, 2007.
  5. Lund University (2005). "Nils Alwall, the artificial kidney and Gambro". Lund University. Archived from the original on December 1, 2008. Retrieved October 3, 2007.
  6. Kurkus, Jan; Marie Nykvist; Birger Lindergård; Mårten Segelmark (2007). "Thirty-Five Years of Hemodialysis: Two Case Reports as a Tribute to Nils Alwall". American Journal of Kidney Diseases. National Kidney Foundation. 49 (3): 471–476. doi:10.1053/j.ajkd.2007.01.022.
  7. HDCN (2002). "Development of Hemodialysis: From Access to Machine". Hypertension, Dialysis, and Clinical Nephrology. Retrieved October 3, 2007.
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