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Principles of Dialysis

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Ultrafiltration

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Ultrafiltration in dialysis is the process where water and dissolved substances are forced across a semi-permeable membrane by a pressure gradient. It helps to remove excess fluid from the patient's body.

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Dry Weight

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Dry Weight is the patient’s weight after all excess fluid is removed via dialysis. Estimating the correct dry weight is important to prevent hypotension or fluid overload in patients undergoing dialysis.

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Osmosis

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Osmosis is the movement of water across a semi-permeable membrane from an area of low solute concentration to high solute concentration. It is important in dialysis to manage fluid balance in the patient.

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Diffusion

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Diffusion in dialysis is the movement of solutes across a semi-permeable membrane from an area of high concentration to low concentration. This is key for removing waste products like urea from the blood.

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Dialysis Access

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Dialysis Access refers to the various means by which dialysis can be administered which includes arteriovenous (AV) fistulae, grafts, and central venous catheters. Proper access care is necessary to prevent infections.

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Peritoneal Dialysis

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Peritoneal Dialysis uses the patient's own peritoneum as the dialysis membrane. A dialysate solution is introduced into the peritoneal cavity, and waste products are filtered into this fluid which is then drained.

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Hemodialysis

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Hemodialysis is a dialysis modality where the patient's blood is filtered outside of the body through a dialyzer or 'artificial kidney'. It's essential for replacing the kidney's filtration function when kidneys are failing.

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Kt/V

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Kt/V is a dimensionless number used to quantify dialysis treatment adequacy. It measures the rate of urea clearance (KK), dialysis time (tt), and urea distribution volume (VV). Target values can help ensure the removal of waste products effectively.

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Dialysate Composition

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The dialysate is the fluid that contains a mixture of pure water, electrolytes, and salts, resembling the plasma concentration. The composition is critical for correcting electrolyte and acid-base imbalances in the patient.

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Dialysis Dose

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Dialysis Dose refers to the amount of dialysis given to a patient, which includes frequency and duration of sessions alongside the dialysate flow rates. It has to be tailored to individual patient needs for optimum treatment outcomes.

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