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Dialysis part 1: The theory
Aims of Dialysis
• Fluid removal
• Solute removal
o Sodium
o Potassium
o Phosphate
o Toxic middle molecular weight molecules
• Extend life
• Be compatible with some quality of life
Haemodialysis 1
• Blood flows from the patient via the pump into the dialysis machine
• Add anticoagulant into the circuit to stop the blot from clotting as it goes
around
• Blood passes through the dialyzer
• Blood passes through many tiny tubes, in the opposite direction dialysate
(dialysis fluid) flows
• Counter current flow helps to maintain the diffusion gradient
Haemodialysis 2
• For dialysis we need a dialyser, dialysis fluid (dialysate), tubing and a
pump to move blood between the patient and dialyser
• Fibres if the dialyser act as a semi-‐permeable membrane across which
blood and dialysate flow in opposite directions
• Typical haemodialysate solution contains sodium, potassium, calcium,
magnesium, chloride, bicarbonate and glucose
Fluid removal
• Fluid removal occurs by a hydrostatic pressure gradient across the
dialysis membrane which Is generated by the dialysis machine
(ultrafiltration)
Solute clearance
Solute is cleared from the intravascular compartment
1) Diffusion
• Diffusion of solute occurs down a concentration gradient
• Blood and dialysate flow In opposite directions across the dialyser to
maximize clearance of solute
2) Convection
• Solute is dragged with the fluid as it moves across the membrane,
depending on pore size