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m is a process of purification and filtration of the

blood enabling the body to get rid of waste
products, excess salts and water from the blood.
This is let pass through a tube to a semi-
permeable membrane (dialyzer) that filters out
waste products and helps the body keep the
biogenic ions balance.

 
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m cemodialysis utilizes counter current flow,
where the dialysate is flowing in the opposite
direction to blood flow in the extracorporeal
circuit.
m ounter-current flow maintains the concentration gradient across the membrane at a
maximum and increases the efficiency of the dialysis.
m Fluid removal (ultrafiltration) is achieved by altering the hydrostatic pressure of the
dialysate compartment, causing free water and some dissolved solutes to move across the
membrane along a created pressure gradient.
m The dialysis solution that is used is a sterilized solution of mineral ions. Urea and other
waste products, potassium, and phosphate diffuse into the dialysis solution. cowever,
concentrations of sodium and chloride are similar to those of normal plasma to prevent
loss. Sodium bicarbonate is added in a higher concentration than plasma to correct blood
acidity. A small amount of glucose is also commonly used.
m The dialyzer consists of a bundle of semi-permeable hollow fibers (tubes)
surrounded by a hard plastic casing (shell). The fibers are potted into the casing
with an impermeable glue at either end. Fluid distribution caps are then glued into
place. Blood can then flow into one fluid distribution cap, along the "
" of the
fiber (tube-side) to the exit distribution cap, and thence out of the dialyzer.
Dialysate, basically distilled water with an electrolyte and pc composition similar
to that of blood plasma, flows counter-current to the blood on the outside of the
fibers (shell-side).
m The procedure is monitored and controlled by a hemodialysis machine, which provides
also the dialysis fluid, mixing it from a concentrate, solids and water. The machine
pumps blood, adds anticoagulants, regulates the purification process and controls the
mixing of dialysis solution and the rate of its flow through the system. It can also monitor
and record the patient's vital characteristics.

Dialysis solution carries away the waste products like urea, creatinine, phosphorus and
excess water, and the cleansed blood is returned to the patient through a shunt.
 Dialysis is conducted in a dedicated facility, either a
special room in a hospital or clinic that specializes in
hemodialysis. Nurses and technicians working in the
facility have special training dedicated to dialysis. The
patient typically receives 2-3 treatments per week, lasting
ususally from 4 to 5 hours each. Patients can read, write,
sleep, have small talks or follow TV.
m