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Dialysis Treatment for Kidney disease

Dialysis Treatment for Kidney disease. By Zachary Jacobson. History. 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

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Dialysis Treatment for Kidney disease

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  1. Dialysis Treatment for Kidney disease By Zachary Jacobson

  2. History • 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

  3. Introduction • 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

  4. Methods • 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

  5. How it Works (PD) • 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

  6. How it works (HD) • 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

  7. Advantages/Disadventages • 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.

  8. Limitations • 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

  9. Future • Shorter Dialysis Time • Increased Efficiency in Filtration • Increased Portability • Recycling of Dialysate • Simultaneous monitoring and introduction of synthetic hormones

  10. Works Cited 1. Salvatore, David. "Evolution and Physical Principles of Convection-based Dialysis Treatment." GiornaleItaliano Di Nefrologia 29.55 (2012): 3-11. Print. 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>.

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