Hemodialysis

Machine
Kidney Function
Calcium
Balance
Vitamin D
Activation
Recovery of
Bicarbonate
Sodium
Removal
Bone Structure
Metabolic End
Products
Cardiac Activity

Regulation of
Blood PH

Blood Pressure
Blood Formation
Removal of Urea ,
Creatinine etc .
Potassium
Balance
Water Balance
Erythropoietin
Synthesis
Need
Dialysis is a treatment for people in the later stage of
kidney failure (chronic renal insufficiency).
This treatment cleans the blood and removes wastes
and excess fluid from the body, which are normally
removed by healthy kidneys.
Sometimes dialysis is a temporary treatment (acute).
However, when the loss of kidney function is
permanent, as in end-stage kidney failure, dialysis is
required on a regular basis (chronic).
The only other treatment for kidney failure is a kidney
transplant.

Types


There are two types of dialysis: hemodialysis
and peritoneal dialysis. In hemodialysis,
blood is passed through an artificial kidney
(hemodialyzer) to clean it.
Peritoneal dialysis uses a filtering process
similar to hemodialysis, but the blood is
cleaned inside the body rather than in a
machine.
The process of diffusion


1.



2.

Blood cells are too big to pass through the dialysis membrane,
but body wastes begin to diffuse (pass) into the dialysis solution.


3.

Diffusion is complete. Body wastes have diffused through the membrane,
and now there are equal amounts of waste in both the blood and the
dialysis solution.




The process of ultrafiltration in PD
11.


2
2.

Blood cells are too big to pass through the semi-permeable membrane,
but water in the blood is drawn into the dialysis fluid by the glucose.

3.

Ultrafiltration is complete. Water has been drawn through the peritoneum
by the glucose in the dialysis fluid by the glucose in the dialysis fluid. There
is now extra water in the dialysis
fluid which need to be changed.
Diffusion
Diffusion / dialysis the movement of solutes
from a compartment in which they are in high
concentration to one in which they are in lower
concentration along an electrochemical
gradient.
An electrolyte solution runs countercurrent to
blood flowing on the other side of a
semipermeable (small pore) filter.
Small molecules such as urea move along the
concentration gradient into the dialysate fluid.
Larger molecules are poorly removed by this
process. Solute removal is directly proportional to
the dialysate flow rate.

Difusion

By controlling the chemicals in the dialysate,
the dialysis machine controls this transfer of
solutes according to the doctor's prescription.
Dialysis machines control the chemicals in
the dialysate by mixing dialysis fluid
concentrates, which are strong versions of
the chemicals, (acetate or sodium
bicarbonate plus acetic acid based solutions)
with purified water
www.health.bcu.ac.uk
Small molecules (less than 68 000 molecular weight) are removed from
the blood by using the high blood pressure to squeeze the molecules
from the glomerulus to the Bowmans capsule.
The small molecules include:
Water
Glucose
Urea
Sodium Chloride
Amino acids and small proteins

Ultrafiltration
Ultrafiltration
Ultrafiltration, also referred to as convection,
is fluid flow through the membrane, forced by
a difference in pressure on the two sides of
the dialyzer (pressure gradient).
This controls the patient's weight loss over
the course of the treatment.
This is very effective in removal of fluid and
middle-sized molecules, which are thought to
cause uremia


Ultrafiltration
While earlier dialysis machines either
controlled dialysate pressure or the pressure
difference across the membrane in order to
achieve ultrafiltration.
Modern dialysis machines are generally
volumetric, meaning they control the volume
of fluid removed from the patient directly and
allowing dialysate pressure to change as it
will in order to achieve the prescribed weight
loss.

Osmosis
Osmosis is the net movement of water
across a selectively permeable membrane
driven by a difference in the amounts of
solute on the two sides of the membrane.
In dialysis, this refers not to water movement
across the hemodialyzer membrane, but
across cell membranes within the body-either
from within the red cells to the blood plasma,
or from within cells of the various tissues in
the body (like muscles) to interstitial fluid (the
fluid in between cells)
Thin material separates the
compartments
Blood and dialysate flow in opposite
directions
Dialysate drains the wastes out of
the blood
Clean blood is returned to the body
Dialyzer Characteristics
1- Biocompatibility( how much a membrane is compatible with human body )
2- Membrane Surface Area
3- Molecular Weight ( the solute size that can pass through the membrane ).
4- Ultrafiltration Coefficient
5- Clearance ( the rate of solute removal )

Dialysis Solution

Dialysis solution, also known as dialysate, is the fluid in
the dialyzer that helps remove wastes and extra fluid
from the blood, as well as regulate blood pH and proper
level of the ion concentrations. It contains chemicals in
low concentrations.

Blood is pumped with the peristaltic pump through the
capillaries, the dialyzing solution is flowing around the
capillaries in opposite direction.
Dialysis Solution (Dialysate)
Function
Fluid in the dialyzer that
contains chemicals in low
concentrations .
This solution are :
Bicarbonate and Acetate .
Functions :-
1-Remove the wastes and
extra fluid from the blood
2-Regulate blood PH and
proper level of the ion
concentration .

Components for Hemodialysis machine
-Single patient hemodialysis systems can be
divided into three major components :-
1- dialysate delivery system.

2- The extracorporeal blood-delivery circuit .

3- The dialyzer .
Components for Hemodialysis machine

How Dialysis Work

Hemodialysis Machine Parts
Parameters monitoring in
Hemodialysis Machine
1- Blood Flow .
2-Dialysate Flow.
3- Dialysate Temperature.
4- Conductivity .
5- Venous and Arterial pressure.
6-Blood in dialysate leaks.
7- Patient blood pressure.
When the air detector senses air it will trigger audible and
visual alarms, stop the blood pump and clamp the venous
blood tubing to keep air from getting into the patients
bloodstream.

Air Detectors
Ultrafiltration
Dialysis machine causes hydraulic pressure
There is higher pressure in blood
compartment than in the dialysate
compartment
This forces water and any other molecules
small enough to pass through the
membrane to evacuate the blood.

Single Patient Dialysate Delivary
System
Volumetric UF Control System
The extracorporeal blood-delivery circuit