Hemodialysis: Difference between revisions
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=== The Dialyzer === | === The Dialyzer === | ||
Dialyzer is usually made of bundles of hollow fibers permitting a high flow rate of blood and dialysate simultaneously. Parallel plates are another type of dialyzer that are barely used recently. | Dialyzer is usually made of bundles of hollow fibers permitting a high flow rate of blood and dialysate simultaneously. Parallel plates are another type of dialyzer that are barely used recently. Most of the dialyzers are synthetic with a variety of materials including polyamide, polyarylethersulfone, polyvinylpyrrolidone, polyacrylonitrile, and polysulfone. Biocompatible membranes have the advantage of not activating complement system. | ||
==Vascular Access== | ==Vascular Access== | ||
Revision as of 19:16, 28 June 2018
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Dialysis Main Page |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
The goals of hemodialysis are removing toxins and aim to maintain euvolemia. Ninety three percent of ESRD patients in the United States and 89% worldwide, are under hemodialysis.[1] Solute diffusion across a membrane is the basic principle for hemodialysis. Metabolic waste products move across a semipermeable membrane depending on their concentration gradient between plasma and dialysate. Concentration gradient, membrane surface area, the membrane thickness, and size of solute molecule are important factors determining rate of diffusion. Small molecules clear more efficiently than larger molecules. Fluid removal is another advantage of hemodialysis that could be achieved by ultrafiltration. In-center hemodialysis and home hemodialysis are available for ESRD patients requiring renal replacement therapy; the choice of modality is based on patient condition, patient preference, and the availability of equipments.
Components
The Dialyzer
Dialyzer is usually made of bundles of hollow fibers permitting a high flow rate of blood and dialysate simultaneously. Parallel plates are another type of dialyzer that are barely used recently. Most of the dialyzers are synthetic with a variety of materials including polyamide, polyarylethersulfone, polyvinylpyrrolidone, polyacrylonitrile, and polysulfone. Biocompatible membranes have the advantage of not activating complement system.
Vascular Access
Anticoagulation
Monitoring and Adequacy
References
- ↑ Collins AJ, Foley RN, Gilbertson DT, Chen SC (June 2015). "United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease". Kidney Int Suppl (2011). 5 (1): 2–7. doi:10.1038/kisup.2015.2. PMC 4455192. PMID 26097778.