In addition to lowering the rate of infection, costs for medical staff and materials had to be decreased. Machines for automated peritoneal dialysis (APD) were developed for this purpose. APD uses a programmable machine, or cycler, that controls the volume, filling, dwell time and drainage of the solution. Thanks to automated dialysis, patients can now be dialyzed while asleep at home.


Schematic structure of the first automated peritoneal dialysis machine by Fred Boen, original drawing in English (1962)


Automated peritoneal dialysis was introduced in 1962 by Fred Boen from Washington University. The machine he developed required a 40-liter container of PD solution. The invention significantly cut the amount of time needed to open and close the tubing system and connect or disconnect bags, as required by manual CAPD. Full containers were delivered to the patients’ homes and retrieved when empty. Intermittent peritoneal dialysis was performed once a week.

It was again Tenckhoff who further simplified automated peritoneal dialysis. To eliminate the difficult task of maneuvering the 40-liter container, he suggested to install water preparation equipment that could provide sterile water at the patients’ homes. A concentrate would then be added to the sterile water to produce dialysis solution.



Precursors of the current peritoneal dialysis machine by Henry Tenckhoff and Norman Lasker


Von 1961 bis 1970 führte Norman Lasker aus den USA die Entwicklungen von Boen, Tenckhoff und Russel Palmer in einer Technologie zusammen. Für „seinen“ Cycler verwendete er Zwei-Liter-Flaschen mit PD-Lösung, die mit Schwerkraft verabreicht wurde. Die Lösung wurde vorher erwärmt. Im Jahr 1970 gingen die ersten Patienten mit diesem Cycler in die Heimdialyse.


The new generation of cyclers developed by Fresenius Medical Care


In 1981, José Diaz-Buxo proposed the continuous cyclic peritoneal dialysis (CCPD), which is now the most commonly used APD method. Here, excess water and toxins are removed from patients overnight using 10 to 15 liters of dialysis solution. During the day, one and a half to two liters of dialysis solution remain in the abdominal cavity.