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Hemodialysis

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General principles of dialysis

Hemodialysis with artificial kidney is done with the help of a special filter, through which the blood is purified from the accumulated useless products of metabolism. These waste products and toxins are filtered through a semipermeable membrane, from the blood to the AMK solution, with which they are removed. The semipermeable membrane acts as a filter with many scattered gaps or pores. The artificial kidney is designed to remove useless metabolic products from the body, restore water and electrolyte balance, and correct acid-base imbalances. The mechanical term for this transfer is called mass transfer and the speed of this motion is called mass transfer rate.

What is dialysis?

Hemodialysis (Hemo-Dialysis, HD) is the method developed to replace renal function and keep alive in patients with severe renal insufficiency.

How is dialysis done?

It is a process in which useless or harmful substances produced daily in the body of kidney patients are transferred from the blood to the dialysis solution. At the same time, substances are reversed from the solution to the patient’s blood. This process takes place with the natural phenomenon of “diffusion” and takes place in a special filter, through membranes that separate the blood from the solution. The Greek name “dialysis” describes exactly the procedure, since with it the patient’s blood is cleansed from toxins and other unwanted substances. The excretion of these substances – which are mainly products of metabolism – is normally done by the kidneys and the substances are excreted in the urine.

Access

To connect the blood with the filter there are three types of vascular access, the fistula (is the anastomosis of an artery in a vein), the implant (is the connection of an artery to a vein through a prosthesis) and the central venous catheter (is a thin hose that is inserted into a large vein in the neck or leg). The central venous catheter is used immediately after placement, while the other two methods require some time to mature.

Dialysis Tips

Patients with CKD often develop anemia, which is a low red blood cell count. This makes them feel tired and can lead to a heart problem called left ventricular hypertrophy. Anemia can be treated with a hormone called erythropoietin (EPO) and extra iron. Correcting anemia helps keep your heart healthy. Calcium and phosphorus should be kept in balance in patients with CKD. This is because the bones lose calcium and weaken over time. Some calcium can end up in parts of the body where it does not belong, such as the heart and blood vessels. This makes the blood vessels harder, less agile and with a narrower lumen. When this happens, we will be more likely to have a heart attack or stroke. Also, patients on dialysis have an increased risk of cardiovascular disease, but can help themselves with prevention. Initially it is necessary to take measures to control health problems that can lead to cardiovascular disease, especially diabetes and high blood pressure. It is essential to follow a healthy lifestyle, patients to eat the right foods, exercise regularly and quit smoking.

Side effects of dialysis

The most common “side effect” of dialysis is hypotensive episodes (significant drop in blood pressure). These episodes are often accompanied by dizziness, a tendency to vomit and a feeling of impending fainting.
Other possible side effects include high blood pressure, cramps, headaches, cardiac arrhythmias and shivering.

Machines

With the use of dialysis machines it is possible for individualized treatment in the patient with end stage renal disease. Specially designed for on-line hemodialysis with a treatment system that includes a wide range of advanced treatment options, such as blood volume monitoring, fistula recirculation assessment and accurate assessment of hemodialysis adequacy at any time (kt / v).

  • Online hemodialysis, the treatment of choice nowadays
  • Advanced patient monitoring systems
  • Absolute safety of the patient with “ultra-pure” water
  • Perfectly designed patient monitoring screen, which in combination with the excellent software of the machine provides the best possible ergonomics for the nurse.

Hemodialysis filters

We offer a range of modern dialysis filters to meet the specific requirements of the various treatments and the individual needs of patients. All filters are based on biocompatible membranes, achieving the maximum therapeutic effect. There are filters with synthetic membranes with anti-allergenic action, filters suitable for patients with very low body weight, for patients with a bleeding mood or heparin allergy.

Key points of the filters we use are:

  • High permeability with Synthetic Alloy Polyamide, Polyaryl Etheresulfone and Polyvinylpyrrolidone (PolyamixTM)
  • The removal of medium and low molecular weight uream toxins in combination with the smallest possible loss of albumin
  • The best possible biocompatibility
  • Excellent hemodynamic behavior
  • High performance during the session

Water Technology

Patients undergoing dialysis are exposed to large amounts of water in the form of dialysis solution during the treatment. Contamination of the solution poses a significant risk to patients undergoing dialysis – stressing the importance of ensuring that only the highest quality water is used. To ensure patient safety, a complete reverse osmosis system with water treatment systems are designed to meet the needs of our patients. Key features of all our water treatment technology products include user-friendly operation, microbiological purity and technical safety. At the same time it is known that cleansing is associated with inflammation and this relationship is fundamental to the onset and progression of cardiovascular disease. Thus, the purity and quality of the dialysis fluid is paramount in providing a “cardioprotective dose” of dialysis and also helps to improve patients’ anemia. The routine of producing ultrapure dialysis fluid also depends on the application of “ultrasounds” within the course of the fluid within the dialysis machine.

To ensure water quality our clinics adopt internationally recognized standards for dialysis water, including the European Committee of Pharmacology, the Association for the Advancement of Medical Instruments (AAMI), the guidelines of the European Society of Nephrologists (ERA-EDTA) and the International Organization for Standardization (ISO).