For the development of renal hemodialysis, which changed kidney failure from a fatal to a treatable disease, prolonging the useful lives of millions of patients.
This year’s Lasker Clinical Medical Research Award honors two scientists who changed kidney failure from a fatal to a treatable disease. By developing the artificial kidney and devising a system for repeating hemodialysis over a period of months and even years, Willem Kolff and Belding Scribner, respectively, have prolonged the useful lives of millions of people.
The fate of kidney patients has undergone a revolution in the last half century, due in large part to Kolff’s and Scribner’s seminal contributions. The kidney filters metabolic byproducts from the blood, and when it fails, patients suffer from a variety of symptoms, including weight loss, nausea and vomiting, gastrointestinal hemorrhaging, itching, lethargy, convulsions, and coma. Without treatment, death ensues. Hemodialyzers replace the cleansing capabilities of the kidney, and although the organ performs other physiological tasks as well, the machine’s ability to extract impurities bestows vitality upon formerly doomed individuals.
Award presentation by Joseph Goldstein
In one of her short stories, the Danish writer Isak Dinesen poses a provocative question: “What is man, when you come to think upon him, but an ingenious machine for turning, with infinite artfulness, the red wine of Shiraz into urine?” Well, when you come to think upon it, this remarkable conversion is carried out by a real ingenious machine, the kidney — a truly remarkable organ. The kidney not only cleanses the blood of toxic products like the red wine of Shiraz, but it also regulates with extraordinary constancy the volume and composition of the body fluids that bathe all the tissues.
Claude Bernard, the great physiologist of the 19th century, pointed out that it is this constancy of the internal environment, orchestrated by the kidney, that allowed animals to achieve a free and independent life. Homer Smith, the great physiologist of the 20th century, had a more watered-down view of the kidney: “Bones can break, muscles can atrophy, glands can loaf, even the brain can go to sleep without immediate danger to survival. But should the kidneys fail — neither bone, muscle, gland, nor brain could carry on.” This is the ultimate kidney-centric view of the world.
Interview with Willem Kolff and Belding Scribner