How an Artificial Kidney is Designed and

Operated
David Belias
Kidney disease affects nearly twenty million people in the United States
1
. When the kidneys
fail, they are no longer able to remove toxic waste products, including urea and creatinine. A
solution to this problem was eventually developed in the mid-1940s. The artificial kidney, also
known as dialyzer, is a simple, yet effective device that uses membranes to filter impurities out
of the blood. There are several designs of dialyzers, but the hollow fiber dialyzer is the best for
high efficiency devices. The design of the device and the principles of mass transfer are the key
factors for its effectiveness.

Design of the Dialyzer
There are only three components of the hollow tube dialyzer, so it is a very simple device. The
components include the jacket, the fiber bundle, and the tube sheet. The jacket encloses the
device, the fiber bundle includes the tubes that the impure blood flows through, and the tube
sheet holds the fiber bundle in place
2
.











Figure 2.
(http://kidney.niddk.nih.gov/kudiseases/pubs/kdictio
nary/images/dialyzer.jpg)
The main components of the
dialyzer are the jacket, fiber
bundle, and tube sheet (black block
holding the fibers).
Jacket
The jacket is made up of plastic and provides a rigid structure for the entire device. The jacket
houses the fiber bundle and tube sheet, protecting these delicate components. The jacket is a
cylinder, with a typical diameter of two inches. At both ends of the jacket, there are caps to close
up the entire device. In the center of the caps are 1/16 holes where the blood enters and leaves.
The last design feature of the jacket is an inlet and an outlet port for the dialysate fluid. The
ports are on the same side of the jacket and the openings are 1/8 to allow the dialysate fluid to
enter and leave. The dialysate fluid is a solution of water and several salts, including sodium
chloride and potassium chloride. The fluid flows through the ports, but is not able to enter the
hollow tubes due to the tube sheet.
Tube Sheet
The tube sheet is a polyurethane block that is located at both ends of the dialyzer. It holds the
fiber bundle in place and prevents the blood from mixing with the dialysate fluid. The tube sheet
forces impure blood from the patient into the fibers of the bundles. In the same way it forces
blood to enter the fibers, it keeps the dialysate fluid in the space surrounding the fibers.
Fiber Bundle
The fiber bundle is the most important component of the hollow tube dialyzer. There are
hundreds of hollow fibers in the bundle. Each of the fibers is comprised of cellophane or a
polymer that has a proprietary formula. This formula is proprietary because its properties greatly
affect the amount of impurity that can be removed from the blood. If it was made public, almost
every brand of artificial kidney would be the same. The thickness of each fiber is approximately
0.025 mm and the diameter is roughly 150 micrometers. The impure blood is fed through each
of the fibers, which allow impurities to be filtered out of the blood. Each fiber acts as a
membrane that is selective to certain compounds. The unwanted impurities are able to cross the
membrane to be swept away by dialysate fluid. On the other hand, the important components of
blood remain, including proteins and blood cells. The fiber bundle is designed so that there is a
space for dialysate fluid to flow between each of the individual fibers. This allows for an
increased surface area, which is important for the science of this purification technique.

Science Behind the Artificial Kidney
Blood enters the dialyzer and is forced into the hundreds of hollow fibers. The tube sheet
ensures that the blood goes directly into the hollow fibers and not into the spaces in between. As
the blood travels through the fibers, waste products are removed. At the same time, dialysate


fluid enters the device and flows into the spaces surrounding the fibers. Throughout this process,
impurities are transferred across the hollow fibers membranes, which is also known as the
phenomenon of mass transfer. This is one of the several scientific considerations for the design
of the hollow fiber dialyzer.
Mass Transfer
The governing phenomenon for hollow tube dialyzers is mass transfer. This device takes
advantage of this molecular phenomenon. Mass transfer occurs due to a concentration driving
force. Mass travels in the direction from a high concentration to a low concentration. The main
impurity in blood that needs to be filtered is urea. The blood entering the dialyzer is
concentrated with urea. On the outside of the fibers, the dialysate fluid enters and it contains no
urea. This creates a large concentration gradient that drives mass transfer of urea out of the
blood and into the dialysate fluid.
Another variable that affects the mass transfer is the surface area. The surface area involved in
this device is the surface area of the hollow fibers. The fibers are cylinders, so the surface area is
equal to 4 times the radius of the fiber squared. This is also known as the contact area between
the fiber and the dialysate fluid. To increase the surface area and thus increase the rate of mass
transfer of urea, spaces are created between the fibers. Since the fibers are separated from each
other, there are more surfaces in contact with the dialysate fluid.
The last variable that determines the rate of mass transfer of urea out of the blood is the mass
transfer coefficient. This is a constant that is determined by the membrane properties and the
flow of dialysate fluid. Some of these properties include membrane pore size and thickness.
Extensive research has been done on the membranes used in this device to maximize the rate of
mass transfer. Researchers are attempting to find materials that have properties that will increase
the mass transfer coefficient. The mass transfer coefficient is also related to the flow of the
dialysate fluid. The faster the flow of fluid, the greater the mass transfer coefficient. A slower
flow rate results in the opposite effect. These three factors are the governing principles for the
effectiveness of a hollow fiber dialyzer.
Co-Current vs. Counter-Current
The other main consideration when designing an artificial kidney is the flow of the dialysate
fluid. It is called co-current if the dialysate fluid is flowing in the same direction as the blood
On the other hand, if the dialysate fluid is flowing in the opposite direction, it is a counter-
current dialyzer
3
. In every case, counter-current is more effective than co-current, so it is used
by this device. Counter-current is more effective because fresh dialysate fluid is constantly
coming in contact with the impure blood. As the dialysate fluid is in contact with the impure
blood for a longer time, it becomes more concentrated with the impure urea. As discussed
before, a more concentrated dialysate fluid decreases the concentration gradient, so there is
slower mass transfer. The co-current design has the dialysate fluid flowing in the same direction
as blood, so there is not fresh dialysate fluid flowing with the blood. As a result, the dialysate
fluid becomes more concentrated, so an even smaller concentration gradient is developed.
Choosing the Flow Rates
In order to maximize urea removal from the blood, proper flow rates need to be chosen for the
blood and dialysate fluid. With a slower flow rate, there is more time for mass transfer to occur
because the dialysate fluid is contacting the blood for longer. As a result, the dialysate becomes
more concentrated, so the concentration driving force decreases and the mass transfer rate
decreases. On the other hand, a faster flow rate creates a larger concentration driving force, but
allows less time for mass transfer to occur. A faster flow rate increases the mass transfer
coefficient, while a slower flow rate does the opposite. Also with a faster flow rate, the dialyzer
needs to be longer to allow enough time for enough impurity to transfer out of the blood. A
slower flow rate decreases the length of the dialyzer due to the opposite effect.
To find the optimum flow rate, a cost analysis is done to find the flow rate that results in the
lowest cost. The capital costs are the costs associated with building the dialyzer, which are
determined by its length. The equipment costs are the costs associated with transporting the fluid
in and out of the device, which are determined by flow rates.
As the description above indicates, the artificial kidney is a very simple device, but there are
numerous design considerations that are involved.











Figure 3.
(http://kidneyschool.org/images/mod10/dialyzer.jpg)
Counter-current flow in the hollow
tube dialyzer.


Conclusion
The artificial kidney is an extremely important device in the medical industry. There are only
three simple components, the fiber bundle, jacket, and the tube sheet, that go into this effective
device. Mass transfer is the main phenomenon that explains the reason that the dialyzer works
so well. There are also design features that need to be considered to optimize the device.
Overall, the artificial kidney is a simple device, but has powerful capabilities.













References
1) 2014 National Chronic Kidney Disease Fact Sheet." Centers for Disease Control and
Prevention. Centers for Disease Control and Prevention, 10 Jan. 2014. Web. 02 May
2014.