When it became clear that Mr. Shields was surviving because of the dialysis treatment, other patients were enrolled. Mr. Harvey Gentry was the next patient enrolled followed by Mr. Rollin Heming and in July 1960, Mr. Jack Capelloto. All were suffering from end-stage renal disease (ESRD), and all received hemodialysis at the University of Washington in Seattle. Scribner recounted his desire to admit additional patients to hemodialysis after the first four patients demonstrated that hemodialysis was effective. However, UW Hospital medical director, John Hogness, refused his request. Hogness believed that once a patient was admitted to chronic hemodialysis, there was an implicit moral imperative that the treatment should continue as long as needed. Hogness knew the university did not have the funds to provide this and felt that from an ethical standpoint, it was not possible to expand the university’s program without a guarantee of funding. He encouraged continuing research aimed at improving this treatment regimen. The success in treating these early patients with chronic renal failure was at first a closely guarded secret out of fear that overwhelming numbers of patients with end-stage renal disease (ESRD) would apply for hemodialysis, once it was discovered to be efficacious and before necessary provisions had been made.

Dr. Scribner described late-night seminars in his hotel room at the annual American Society for Artificial Internal Organs (ASAIO) meeting in Atlantic City, 1960. He and Quentin demonstrated to nine nephrologists the art of “tube bending” so they could return home, make their own cannulas, and enroll their ESRD patients in hemodialysis programs in cities across the country. Scribner actually brought Mr. Shields to Atlantic City as a living demonstration of the month-long success of his treatment. Dr. Shreiner, president of ASAIO, allowed a brief paper written by Scribner describing his technique in chronic hemodialysis to be published in the report on the ASAIO meeting, even though Scribner had not been on the program due to the late breaking nature of his discovery. Gradually, as word spread, nephrologists and nurses from throughout the USA flocked to Seattle, WA, to learn about hemodialysis.

Scribner recognized the financial problems in expanding the hemodialysis program at the University of Washington. Once a patient was accepted for dialysis, the patient would need treatment three times per week for the rest of his/her life. How was such treatment to be paid for? Scribner, with the support of the dean of the medical school, Dr. George Aagaard (1954–1964), appealed for assistance from the community. Dr. James W. Haviland, then president of the King County Medical Society, responded to Scribner’s request for community support. He assisted through donations and a grant from the Hartford Foundation in establishing the world’s first hemodialysis center. On January 1, 1962, the Seattle Artificial Kidney Center (SAKC) opened in the former nurses’ quarters in the basement of Swedish Hospital. It was a nonprofit organization dedicated to the care of hemodialysis patients. The SAKC was a novel operation at the time as the task of hemodialysis was turned over to the nurses. Scribner never sought a patent on his invention as his goal was to keep the costs down and to provide hemodialysis for all who need it. Seattle became a leader in teaching patients and their families the methods of “home dialysis.” This was more convenient for patients and more cost-effective. Dr. Christopher Blagg, a colleague with Scribner in the Division of Nephrology from 1963, became executive director of the newly renamed Northwest Kidney Centers from 1971 until 1998, a period of amazing growth in the treatment of dialysis patients [3].