APPLICATION 1: HEMODIALYSIS Hemodialysis is a type of dialysis treatment.

It is the most common method used to treat advanced and permanent kidney failure. Healthy kidneys clean our blood by

removing excess fluid, minerals, and wastes. When our kidney are no longer able to filter the blood and make urine, it causes toxins and excess fluid to build up in the body. Hemodialysis is the process of removing blood from the body, pumping it into a machine that removes toxic substances by diffusion, and then returns the purified blood to the patient. The main concept of kidney that I want to focus here is osmoregulation.

Osmoregulation is the regulation of water content and solute concentration of body fluids.

Figure 1: A hemodialysis machine (Source : Wikipedia, 2007) Osmoregulation will be disturbed when the kidney fail to work. One cause of

osmoregulation disturbance is when there are problems on glomerular ultrafiltration process that occur on renal corpuscles. Ultrafiltration is the separation of large

molecules from small molecules by a very fine filter. Glomerulonephritis is a disease related on glomerular ultrafiltration problem. In this disease, an abnormal immune

response to an infection causes the antigen and antibody to fuse into insoluble particles, which are trapped in the glomeruli, resulting in inflammation and death of the tubules. The dialyzer is the key to hemodialysis. The dialyzer is called the artificial kidney because it filters the blood that is a job a kidney used to do. The dialyzer is a hollow plastic tube that contain many tiny filters. The two sections are devided by a A semipermeable

semipermeable membrane so that they do not mix together.

membrane has microscopic holes that allow only some substances to cross the membrane. Because it is semipermeable, the membrane allows water and waste to pass through, but does not allow blood cell to pass trough.

Figure 2: Hemodialysis schematic (Source : Bethesda, 2006) Dialysate, also called dialysis fluid, is a solution of pure water, electrolytes and salts, such as bicarbonate and sodium. The purpose of dialysate is to pull toxins from the blood into dialysate. The way this works is through a process called diffusion. In the blood of hemodialysis patient, there is a high concentration of wastes, while the dialysate has a low concentration of waste. Due to the difference in concentration, the waste will move to the semipermeable membrane to create an equal amount on both sides. The dialysis solution is then flushed down the drain along with the waste. The electrolytes in the dialysis solution are also used to balance the electrolytes in the patients blood. The extra fluid is removed through a process called filtration. The fluid is pushed off by higher pressure on the blood side than on the dialysate side. Hemodialysis is a treatment that help replace the work of our kidney. treatment help we feel better and live longer, but it do not cure kidney failure. This