The initial observations of dialytic support were brought from the
laboratory and confined to patients with reversible acute renal
failure. The thought at that time was one of short term
maintenance. It was theorized that removal of waste products from
the blood, albeit incomplete and inefficient, might allow these
patients time to regenerate damaged tubules and regain renal
function. After a dis appointing earlier experience in survival,
greater sophisti cation and broader practice refined the dialysis
skills and reduced mortality. It also became apparent that long
periods of support were possible and successful attempts were then
made in utilizing this technology in patients with chronic renal
failure. These early young patients were a very select group who
possessed only renal dysfunction and no other systemic involvement.
Nonetheless, they demonstrated a one year survival of only 55-64%.
There are presently over 80,000 patients on dialytic support in the
United States and over 250,000 patients worldwide dependent on
artificial replace ment. Mortality statistics vary but despite a
20-30% systemic disease involvement and a fifth decade average age
in the North American experience, the one year survival has risen
to apparently 90%."
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