A new approach to the treatment of renal failure.

There is an apparent need for an alternative form of treatment for renal failure. In this study, therefore, an attempt was made to determine the feasibility of dialysing across an isolated loop of colon and its possible application to augment failing renal function in patients with chronic uraemia.Colonic loops were isolated in sheep and studies performed to find an effective solution in terms of urea clearance. The best solution was then used (1) changing the speed of flow, (2) changing its temperature, and (3) with the addition of vasodilators. It was then used in animals subjected to bilateral nephrectomy and, compared with control animals, life was prolonged significantly (P<0.03). Dialysis was also carried out on sheep made temporarily uraemic by injecting them subcutaneously with ureaphil and also on sheep in which chronic uraemia had been induced by an immunological method. These animals also lived significantly longer than controls (P<0.05). Antibody titres in these sheep were estimated and found to be higher than in non-dialysed uraemic animals.Once it had been established that urea could be removed across the colonic mucosa this method of dialysis was used in patients with established isolated loops of colon. Even though they had normal blood levels urea was recovered in the dialysate. The results indicate that colonic dialysis, which is simple and inexpensive, may have a place as an adjunctive therapy in the treatment of chronic renal failure.