AGRAVANTES, DENNISE

LAROYA, DONITA
REYES, VALLERIE
PRINCIPLES OF HEMODIALYSIS
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Hemodialysis:

>Remove accumulated
metabolic waste
products

>Correct blood electrolyte
composition

>By means of exchange
between patients blood
& dialysate fluid across a
semi-permeable
membrane
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Dialyzer

>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.
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Dialyzer

>Fluid distribution caps
are then glued into place

>Blood can then flow into
one fluid distribution
cap, along the interior of
the fiber (tube-side) to
the exit distribution cap,
and thence out of the
dialyzer.
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Dialyzer

>Dialysate, basically
distilled water with
an electrolyte and pH
composition similar
to that of blood
plasma, flows
counter-current to
the blood on the
outside of the fibers
(shell-side).
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Dialysis CAN
Remove waste products
(e.g. urea, creatinine,
phosphorus, etc.)
Remove excess water
Correct high or imbalanced
levels of potassium, chloride,
sodium, etc. in the blood
Dialysis CANT
Automatically regulate
blood pressure
Produce hormones like
Erythropoetin (EPO)
Regulate normal calcium
levels
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Electrolyte balance
>adding some electrolytes to
your dialysate solution
excess electrolytes are
removed as part of your
treatment

>The goal is to get the right
amount of the right
electrolytes.
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Removing excess water

>ultrafiltration.

>the dialysis machine puts
pressure on the blood side of
the semi permeable membrane
in the dialyzer.

>This pressure forces salt and
water out of the blood and
into the dialysate.

>The used dialysate with the
blood wastes and excess fluid
is taken away and drained.
CURRENT TRENDS

New Dialysis Method Cuts
Mortality Risk

Published: Feb 16, 2013
By Michael Smith , North American
Correspondent, MedPage Today

HEMODIALYSIS ACCESS
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ARTERIOVENOUS FISTULA:
>An AV fistula requires advance
planning

>A surgeon creates an AV fistula by
connecting an artery directly to a
vein, frequently in the forearm.

>As a result, the vein grows larger and
stronger, making repeated needle
insertions for hemodialysis treatments
easier.
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ARTERIOVENOUS GRAFT
The graft becomes an artificial vein that
can be used repeatedly for needle
placement and blood access during
hemodialysis.
often within 2 or 3 weeks.

Compared with properly formed fistulas,
grafts tend to have more problems with
clotting and infection and need
replacement sooner.
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VENOUS CATHETER FOR TEMPORARY
ACCESS
>A catheter is a tube inserted into a vein
in your neck, chest, or leg near the
groin.
>It has two chambers to allow a two-way
flow of blood.
>Catheters are not ideal for permanent
access.
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The most common area:
1. Internal jugular catheter
- inserted into the jugular vein on
the side of the neck.

2. Subclavian catheter -
placed into the subclavian vein
under the collar bone on the
chest.

3. Femoral catheter - placed in
the large vein in the leg near the
groin.
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