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    37.principle of HD

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    anandafauzia
    Hemodialysis removes waste and corrects electrolyte and acid-base imbalances through diffusion and ultrafiltration across a semi-permeable membrane. Solutes move from higher to lower concentration by diffusion, while fluid is removed by creating a pressure gradient (ultrafiltration). Both diffusion and convection (solutes carried along with fluid) contribute to solute clearance during hemodialysis.

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    37.principle of HD

    Uploaded by

    anandafauzia
    191 views24 pages
    Hemodialysis removes waste and corrects electrolyte and acid-base imbalances through diffusion and ultrafiltration across a semi-permeable membrane. Solutes move from higher to lower concentration by diffusion, while fluid is removed by creating a pressure gradient (ultrafiltration). Both diffusion and convection (solutes carried along with fluid) contribute to solute clearance during hemodialysis.

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    37.Principle of HD

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    Hemodialysis removes waste and corrects electrolyte and acid-base imbalances through diffusion and ultrafiltration across a semi-permeable membrane. Solutes move from higher to lower concentration by diffusion, while fluid is removed by creating a pressure gradient (ultrafiltration). Both diffusion and convection (solutes carried along with fluid) contribute to solute clearance during hemodialysis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    191 views24 pages

    37.principle of HD

    Uploaded by

    anandafauzia
    Hemodialysis removes waste and corrects electrolyte and acid-base imbalances through diffusion and ultrafiltration across a semi-permeable membrane. Solutes move from higher to lower concentration by diffusion, while fluid is removed by creating a pressure gradient (ultrafiltration). Both diffusion and convection (solutes carried along with fluid) contribute to solute clearance during hemodialysis.

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    © All Rights Reserved
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    Download as ppt, pdf, or txt
    of 24

    Principle of

    Hemo (dialysis)
    HEMODIALYSIS
    Diffusion

    HEMOFILTRATION :
    Convection
    Principle of Hemodialysis

    • Dialysis removes nitrogenous (and other)


    waste products, and corrects the electrolyte,
    water, and acid base abnormalities associated
    with renal failure.
    • It requires the use of semi-permeable
    membrane which allow the passage of water
    and small molecular weight solutes, but not
    large molecules.
    Dialysis: General Principles

    • Diffusion
    – Movement of solutes from an area of greater
    concentration to lesser concentration

    • Osmosis
    – Movement of fluid from an area of lesser to an area of
    greater concentration of solutes.

    • Ultrafiltration (water & fluid removal)


    – Movement of fluid across a semipermeable membrane
    as a result of an artificially created pressure gradient.
    Diffusion
    Ultrafiltration
    A B A B

    Diffusion

    t=0 t = equilibrium
    Membrane

    Membrane
    A B A B

    t=0 t = later
    Ultrafiltration

    The Process of diffusion (top) and ultrafiltration (bottom)


    Hemodialysis Filter
    Mechanisms of Solute Removal

    1. Diffusion

    2. Convection

    3. Diffusion + Convection

    4. Adsorbtion
    Solute Clearance
    Blood Membrane Dialysate/Ultrafitrate
    Diffusive Solute Clearance
    Blood Membrane Dialysate/Ultrafitrate
    Diffusive Solute Clearance
    Blood Membrane Dialysate/Ultrafitrate
    Convection
    Adsorption

    ADSORPTION: molecular adherence to the surface


    or interior of the membrane.
    Ultrafiltration

    ULTRAFILTRATION: The movement of fluid through a membrane


    caused by a pressure gradient.
    Water movement during standard hemodialysis

    Intracellular fluid Extracellular fluid Dialyzer

    step3

    Water movement step1


    280
    Loss of urea
    and water

    Osmolality
    Osmolality 320 mosm/kg
    320 mosm/kg Falling to
    step2
    290mosm/kg
    as diffusion occurs

    Compensatory refilling
    A “Standard” HD Delivery System
    Informational Display Saline

    PT = Pressure
    Transducer Anticoagulant

    PT
    Blood from Patient

    Dialysate / UF Out (green


    / yellow)
    Blood Leak Conductivity
    Detector
    PT
    Meter
    Mixing
    Dialysate In System Pre-mixed or
    sorbent
    Water, Acid Concentrate,
    PT regenerated
    Bicarbonate Concentrate
    dialysate
    In

    Air Venous
    Drip Chamber clamp
    Detector

    Blood return to
    18
    Patient
    Solute Transfer & Ultrafiltration

    C blood > C Dialysate


    P blood >≈ P Dialysate

    Blood Dialysate
    Ur Cr Ur Cr Ur Cr Ur Ur Ur Ur
    Cr Cr
    Cr
    Ur Cr Ur Cr
    Cr Ur Cr Ur Ur Ur Ur

    A semi-permeable membrane

    Ur Cr Ur Ur Ur
    Ur Cr
    Ur Cr
    Ur Ur
    Cr

    START DIFFUSION SOME DIFFUSION NO DIFFUSION


    Ur
    Ur
    Ur Ur
    Ur Ur

    A semi-permeable membrane

    START DIFFUSION SOME DIFFUSION NO DIFFUSION


    Ur Cr Ur Cr Ur Cr Ur Ur
    Cr
    Cr Ur Cr
    Cr Ur
    Ur Ur Cr Cr Ur Ur Cr
    Ur

    A semi-permeable membrane

    Ur Ur Ur Ur Ur
    Cr Cr
    Cr
    Ur Ur Ur

    DIFFUSION DIFFUSION DIFFUSION


    Ur
    Ur
    Ur Ur
    Ur Ur

    A semi-permeable membrane

    DIFFUSION DIFFUSION DIFFUSION

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