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Published on: July 19, 2018
[Renal replacement therapy by hemodialysis: an overview]
1Service de néphrologie, groupe hospitalier Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. claude.jacobs@psl.aphp.fr
Nephrologie & Therapeutique
|June 2, 2009
Summary
Hemodialysis (HD) replaced kidney function with artificial devices, evolving from early diffusion principles to modern artificial kidneys (AK). Ongoing advancements aim for wearable devices mimicking natural kidney functions for renal failure treatment.
Area of Science:
- Nephrology and Bioengineering: Focuses on the development and application of artificial kidney technology for renal replacement therapy.
Context:
- The invention of hemodialysis (HD) marked a milestone in medicine, enabling artificial replacement of vital kidney functions.
- Early pioneers like Thomas Graham and Abel et al. laid the groundwork for dialysis technology, with Haas introducing heparin as an anticoagulant.
Purpose:
- To trace the historical evolution of hemodialysis (HD) from its conceptual origins to its current sophisticated applications in treating renal failure.
- To highlight key technological advancements, including the development of artificial kidneys (AK), improved membranes, and vascular access methods.
Summary:
- Hemodialysis (HD) technology has advanced significantly since its inception, with key developments including the rotating drum kidney, arteriovenous shunts, and AV fistulas.
- Modern HD therapy focuses on optimizing treatment adequacy (Kt/V), managing complications like uremic toxins and anemia, and improving patient quality of life.
- Future innovations aim to create wearable artificial kidneys with integrated regulatory functions, moving closer to replicating natural kidney physiology.
Impact:
- Hemodialysis is a critical life-sustaining treatment for acute renal failure (ARF) and end-stage chronic renal failure (ESRF), enabling long-term patient survival.
- Continuous research into biocompatible membranes, efficient toxin removal, and nanotechnology promises further improvements in HD therapy and patient outcomes.
- The development of wearable and implantable devices represents a paradigm shift, potentially offering more comprehensive renal replacement therapy.
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