Nils Alwall

Nils Alwall (1904, Kiaby – 1986), a Swedish professor, 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. Alwall is referred to as the "father of extracorporeal blood treatment."

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. Dr. Nils 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 renal failure on the September 3, 1946, who responded well to the treatment but died of pneumonia a short while after.

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 1500 patients in renal 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.

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.

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