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By Zachary Jacobson
First practiced on animals in early 1900’s
Developed by Dr. Willem Kolff in 1943
First successful treatment administered in 1945
In 1950’s Dr. Belding Scribner uses Teflon tubing Scribner heralded as father
of bioethics Scribner starts first
outpatient facility in 1962
Function of Kidneys Nephrons, glomeruli and waste tubules Hormone secretion support homeostasis
Causes of Chronic Kidney Disease/Failure Hypertension Diabetes mellitus (3 types)
Diagnosing KidneyDisease/Failure Elevated proteins and/or blood in urine
Function of Dialysis Filter waste and excess fluid from blood
Dialysis requires surgery to develop access site 3 types: fistula, graft, catheter
Filter Membrane Semi-permeable quality allows only smaller
materials(i.e. waste) to diffuse across Larger waste products and excess fluid require
ultrafiltration Dialysate
Composed of sterile water, electrolytes/chemicals and dextrose Dextrose concentration determines osmotic
pressure in PD exchange
Peritoneal Dialysis Creation of access site
Permenant Peritoneal Catheter
Dialysate drawn into abdominal cavity
Peritoneum acts as filter Waste stored in dialysate Dextrose level determines
ultrafiltration rate 2 types: CAPD, CCPD Dialysate drained from cavity
Hemodialysis Blood filtered outside of body
Dialyser Filters through synthetic
membrane Thousands of thin hollow fibers Countercurrent ultrafiltration Different types of filters
Dialysis Machine Monitors time, temp, pressure
Blood returned to body through access
PD vs. HD HD uses more predictable membrane PD is easier to use and more convenient PD less likely to cause Hypotension PD may cause trouble breathing
Dialysis patients require special diet and medication to replace hormonal function.
PD and HD do not replicate all kidney functions
Access sites can move or become infected
Limited movement Body image Time per treatment Blood clotting Expensive without health coverage
Shorter Dialysis Time Increased Efficiency in Filtration Increased Portability Recycling of Dialysate Simultaneous monitoring and
introduction of synthetic hormones
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2. Wakasugi, M., Kawamura, K., Yamamoto, S., Kazama, J. J. and Narita, I. (2012), High Mortality Rate of Infectious Diseases in Dialysis Patients: A Comparison With the General Population in Japan. Therapeutic Apheresis and Dialysis, 16: 226–231. doi: 10.1111/j.1744-9987.2012.01062.x
3. Saran, R., J. L. Bragg-Gresham, N. W. Levin, Z. J. Twardowski, V. Wizemann, A. Saito, N. Kimata, B. W. Gillespie, C. Combe, J. Bommer, T. Akiba, D. L. Mapes, E. W. Young, and F. K. Port. "Longer Treatment Time and Slower Ultrafiltration in Hemodialysis: Associations with Reduced Mortality in the DOPPS." Kidney International 69.7 (2006): 1222-228. Print.
4. "Home Dialysis Central." Home Dialysis Central. Medical Education Institute, Inc, Oct. 2012. Web. 22 Oct. 2012. <http://homedialysis.org/>.
5. Vienken, Jörg, Michael Diamantoglou, Werner Henne, and Bernd Nederlof. "Artificial Dialysis Membranes: From Concept to Large Scale Production." American Journal of Nephrology 19.2 (1999): 355-62. Print.
6. Misra, Madhukar. "The Basics of Hemodialysis Equipment." Hemodialysis International 9.1 (2005): 30-36. Print.
7. "Dialysis." Wikipedia. Wikimedia Foundation, 22 Oct. 2012. Web. 22 Oct. 2012. <http://en.wikipedia.org/wiki/Dialysis>.