Hemodialysis

Hemodialysis- Introduction

Hemodialysis is an advanced and permeant method to treat kidney failures.

It is treatment used for removal kidneys renal failure cases and this
treatment separates waste product such as urine , creatinine , water from
blood.

Hemodialysis (machine) pumps the patients blood against dialysate that

may be generated by the dialysis machine or at a central location (ASN
2015).

Dialysis machines includes pumps, monitors, and alarms that allow safe
proportioning of dialysate.

A modern
hemodialysis
machine

Source: http://commons.wikimedia.org/wiki/File:Hemodialysis_machine_INNOVA.jpg

Hemodialysis machine and process

Biomaterial considerations

Hemodialysis serve as artificial kidney requires material that function

in contact with blood and have appropriate permeability & mass
transport characteristics (Ratner 2004).

1)

dialyses membranes which come in to contact with blood may cause

humoral and cellular inflammatory reactions maybe triggered
(Krmczi, Rosenkranz, & Zlabinger, 1999).

2)

Therefore a biocompatible biomaterial should be used to avoid such

reactions.

Materials commonly used

1)

Polysulfone a family of thermoplastic polymers.

It has high toughness and has stability at high temperatures.

Its hydrolyses stability let it to form membrane reproducible properties and

controllable size of pores down to 40 nanometers (Mandolfo, Malberti et al.
2003).

These membrane are used in hmodialysis to remove water from blood.

These membrane permits low molecular weight soultes as urine , water but
prevent high molecular weight blood and protiens.

Polysulfone proved a better biocompitable mebrane then other cellulose

meterials (Kubala, Ciz, Soska, Cerny, & Lojek, 2002).

Materials commonly used

1)

Silicone rubber (medical grade silicone ) is an elastomer.

It has high resistant to extreme environment temperature.

It is non-reactive and stable.

It is Used in tubing , catheters, drains , feeding tubes.

Emerging trend in the device design

The key components of the

hemodialysis machine

Heating

De-aeration

Proportioning

Monitoring

Ultrafiltration

Disinfection

Source: (ASN, 2015)

Emerging trend in the device design

Out break of infection due to the use of machine.

The new biomaterials are introduced to reduce the infections

Research in the area to improve the biocompatibility of the device and

biometerials

Major advances have occurred in membrane technology with the

development of more biocompatible dialyzer membranes (Radovich,
1995).

Use of high flux biocompatible membranes (Woods & Nandakumar,

2000)

contemporary issues

Patient safety

Low blood pressure (hypotension)

Muscle cramps

Anemia

Bone diseases

High blood pressure (hypertension)

References (Endnote Harvard

format)

ASN 2015. American Society of Nephrology. https://www.asn-online.org/.

KRMCZI, G. F., ROSENKRANZ, A. R. & ZLABINGER, G. J. 1999. Polymorphonuclear granulocyte

stimulation by cellulose-based hemodialysis membranes. Clinical chemistry and laboratory
medicine, 37, 351-355.

KUBALA, L., CIZ, M., SOSKA, V., CERNY, J. & LOJEK, A. 2002. Influence of polysulfone and hemophan
hemodialysis membranes on phagocytes. General physiology and biophysics, 21, 367-380.

MANDOLFO, S., MALBERTI, F., IMBASCIATI, E., COGLIATI, P. & GAULY, A. 2003. Impact of blood and
dialysate flow and surface on performance of new polysulfone hemodialysis dialyzers. The
International journal of artificial organs, 26, 113-120.

RADOVICH, J. 1995. Composition of polymer membranes for therapies of end-stage renal disease.
Contributions to nephrology, 113, 11.

RATNER, B. D. 2004. Biomaterials science: an introduction to materials in medicine, Academic press.

WOODS, H. & NANDAKUMAR, M. 2000. Improved outcome for haemodialysis patients treated with
high-flux membranes. Nephrology Dialysis Transplantation, 15, 36-42.