Overview of the hemodialysis apparatus
- Rebecca J Schmidt, DO, FACP
Rebecca J Schmidt, DO, FACP
- Professor of Medicine
- West Virginia University School of Medicine
- Jean L Holley, MD, FACP
Jean L Holley, MD, FACP
- Clinical Professor of Medicine
- University of Illinois, Urbana-Champaign
For patients with end-stage renal disease (ESRD), renal replacement therapy is achieved by dialysis (hemodialysis or peritoneal dialysis) or kidney transplantation. Although true and complete replacement of renal function is not provided by dialysis, this modality removes metabolic wastes and excess body water and replenishes body buffers in order to sustain life.
The apparatus used to conduct hemodialysis consists of the following components:
●Dialysis solution (dialysate)
●Tubing for transport of blood and dialysis solutionTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Keshaviah P. Technology and clinical application of hemodialysis. In: The Principles and Practice of Nephrology, Jacobson HR, Striker GE, Klahr S (Eds), BC Decker, Philadelphia 1991. p.740.
- Salem M, Mujais SK. Dialyzers. In: Dialysis Therapy, Nissensen AR, Fine RN (Eds), Hanley & Belfus, Philadelphia 1993. p.65.
- Ahmad S, Misra M, Hoenich N, Daugirdas JT. Hemodialysis apparatus. In: Handbook of Dialysis, 4th ed., Daugirdas JT, Blake PG, Ing TS (Eds), Lippincott, Williams & Wilkins, Philadelphia 2007. p.59.
- Misra M. The basics of hemodialysis equipment. Hemodial Int 2005; 9:30.
- Bouré T, Vanholder R. Which dialyser membrane to choose? Nephrol Dial Transplant 2004; 19:293.
- Abe M, Hamano T, Wada A, et al. High-Performance Membrane Dialyzers and Mortality in Hemodialysis Patients: A 2-Year Cohort Study from the Annual Survey of the Japanese Renal Data Registry. Am J Nephrol 2017; 46:82.
- Pyo HJ, Kwon YJ, Wee KS, et al. An outbreak of Heinz body positive hemolytic anemia in chronic hemodialysis patients. Korean J Intern Med 1993; 8:93.
- Medarov BI, Pahwa S, Reed S, et al. Methemoglobinemia Caused by Portable Dialysis in the Critically Ill. Crit Care Med 2017; 45:e232.
- Brunet P, Berland Y. Water quality and complications of haemodialysis. Nephrol Dial Transplant 2000; 15:578.
- Laurence RA, Lapierre ST. Quality of hemodialysis water: a 7-year multicenter study. Am J Kidney Dis 1995; 25:738.
- Munoz Mendoza J, Sun S, Chertow GM, et al. Dialysate sodium and sodium gradient in maintenance hemodialysis: a neglected sodium restriction approach? Nephrol Dial Transplant 2011; 26:1281.
- Keen ML, Gotch FA. The association of the sodium "setpoint" to interdialytic weight gain and blood pressure in hemodialysis patients. Int J Artif Organs 2007; 30:971.
- Santos SF, Peixoto AJ. Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients. Clin J Am Soc Nephrol 2008; 3:522.
- Arramreddy R, Sun SJ, Munoz Mendoza J, et al. Individualized reduction in dialysate sodium in conventional in-center hemodialysis. Hemodial Int 2012; 16:473.
- Munoz Mendoza J, Bayes LY, Sun S, et al. Effect of lowering dialysate sodium concentration on interdialytic weight gain and blood pressure in patients undergoing thrice-weekly in-center nocturnal hemodialysis: a quality improvement study. Am J Kidney Dis 2011; 58:956.
- Levin A, Goldstein MB. The benefits and side effects of ramped hypertonic sodium dialysis. J Am Soc Nephrol 1996; 7:242.
- Diamond SM, Henrich WL. Acetate dialysate versus bicarbonate dialysate: a continuing controversy. Am J Kidney Dis 1987; 9:3.
- Flanigan MJ, Khairullah QT, Lim VS. Dialysate sodium delivery can alter chronic blood pressure management. Am J Kidney Dis 1997; 29:383.
- Sang GL, Kovithavongs C, Ulan R, Kjellstrand CM. Sodium ramping in hemodialysis: a study of beneficial and adverse effects. Am J Kidney Dis 1997; 29:669.
- Pastan S, Bailey J. Dialysis therapy. N Engl J Med 1998; 338:1428.
- http://fmcna-bibag.com/ (Accessed on September 13, 2017).
- Brunelli SM, Sibbel S, Do TP, et al. Facility Dialysate Calcium Practices and Clinical Outcomes Among Patients Receiving Hemodialysis: A Retrospective Observational Study. Am J Kidney Dis 2015; 66:655.
- http://www.fmcna-bloodlines.com/ (Accessed on September 13, 2017).
- SOLUTE CLEARANCE
- Diffusive transport
- Convective transport
- Flow rates
- FLUID REMOVAL
- Dialyzer types
- - Type of membrane material
- - Blood volume capacity
- - Surface area
- - Clearance
- - Ultrafiltration coefficient
- - Sterilization and reuse
- DIALYSIS SOLUTION
- - Aluminum
- - Copper and chloramine
- - Bacteria
- - Endotoxin
- Components of the dialysate
- DIALYSIS TUBING
- DIALYSIS MACHINES
- INFORMATION FOR PATIENTS