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Dialysis01:15

Dialysis

2.0K
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Dialysis01:27

Dialysis

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

1.4K
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

2.6K
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
737
Peritoneal Dialysis I: Introduction and Procedure01:30

Peritoneal Dialysis I: Introduction and Procedure

4.9K
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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The effect of changes in intra-compartmental bioimpedance measurements with early intra-dialytic hypotension during haemodialysis.

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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

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New Dialysis Technology and Biocompatible Materials.

Andrew Davenport1

  • 1UCL Centre for Nephrology, University College London Medical School, London, UK.

Contributions to Nephrology
|December 13, 2016
PubMed
Summary

Improving haemodialysis by enhancing toxin removal may improve patient survival. Newer techniques like haemodiafiltration and adsorption devices show promise for clearing more waste products, potentially reducing high mortality rates in dialysis patients.

Area of Science:

  • Nephrology
  • Biomedical Engineering
  • Materials Science

Background:

  • End-stage kidney disease (ESKD) affects over 2 million patients globally, with high mortality despite haemodialysis.
  • Current haemodialysis methods show limited efficacy in clearing certain metabolic waste products, contributing to poor patient outcomes.
  • Protein-bound toxins accumulate, increasing cardiovascular morbidity and mortality in dialysis patients.

Purpose of the Study:

  • To evaluate the impact of enhanced toxin clearance on patient survival in haemodialysis.
  • To explore novel dialyser designs and adsorption technologies for improved waste product removal.
  • To address the limitations of current dialysis techniques in managing protein-bound toxins.

Main Methods:

  • Review of recent reports on haemodiafiltration and patient survival.

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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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  • Development of microfluidic and superflux dialyser designs for enhanced middle-molecule and larger-molecule clearance.
  • Investigation of adsorption devices utilizing activated carbon and composite membranes for toxin removal.
  • Assessment of historical data on anaphylactoid reactions and strategies to mitigate leaching of organic chemicals.

    • Main Results:

    • Higher-volume haemodiafiltration is associated with improved patient survival.
    • Newer dialyser designs aim to increase clearance of middle and larger-molecular-weight toxins.
    • Adsorption technologies are being revisited to target protein-bound toxins.
    • Improvements in dialyser biocompatibility and sterilization have reduced anaphylactoid reactions.

    Conclusions:

    • Enhanced convective and adsorptive clearance strategies are crucial for improving outcomes in haemodialysis.
    • Further clinical trials are needed to validate the efficacy of novel dialyser technologies.
    • Managing protein-bound toxins and minimizing exposure to leached chemicals are key areas for future research in dialysis treatment.