Kidney Failure: HemodialysisBy :Andrew McNaught

Function of the Kidneys

• Regulate the composition of your blood

– Keep the volume of water in your body constant

– Remove wastes from your body (urea, ammonia, drugs, toxic substances)

– Keep the acid/base concentration of your blood constant

• Help regulate your blood pressure

• Stimulate the making of red blood cells

• Maintain your body's calcium levels

• Your kidneys filter all your blood (7-8 pints) once every hour

Sources of kidney failure

• Alcohol/drug abuse

• Medications (anti-inflammatory drugs) that are toxic to the kidney (ex. Ibuprophen and naproxen)

• Abnormal blood flow to and from the kidneys

– Prostate cancer

– Tumors around the kidney

– Kidney stones

• Multiple myeloma – cancer of blood plasma

When the kidneys fail..

• High levels of acidity in the blood will alter enzyme and oxygen metabolism causing organ failure.

• The kidneys cannot address the rising acid load in the body, breathing becomes more rapid as the lungs try to buffer the acidity by blowing off carbon dioxide

• Rising urea levels in blood can affect many organs.

• General weakness due to anemia (low red blood cell count)

Hemodialysis

• Inpatient or at home procedure that takes the blood and filters it through a machine

• People with chronic kidney disease (CKD) will usually use the at-home option

– To test for CKD, a patients blood is taken and if there are high levels of creatine, it shows that the kidney is failing.

How hemodialysis works

An inside look at hemodialysis

Comparing hemodialysis to kidney

At Home Hemodialysis Conventional Hemodialysis

• Conventional HHD - done three times a week for four hours. It is like in-centre hemodialysis (IHD), but done at home.

• Short daily home hemodialysis (SDHHD) - done five to seven times a week for approximately two hours per session.

• Nocturnal home hemodialysis (NHHD) - done 3 to seven times per week at night.

• Conventional hemodialysis is done about three times a week. In this form of treatment, it takes 3-4 hours per session

Side Effects/complications

• The initial insertion of the needle is painful to many but can be overcome by a numbing spray

• Removing too much fluid or fluid too fast can cause nausea, fatigue, low blood pressure, chest pains, leg cramps. (Wash out)

• Hemodialysis exposes the circulatory system so infections such as sepsis(infection of the heart valves) and osteomyelitis (infection of the bones).

• Heparin(anti coagulant) allergy

AWAK

AWAK• Automated wearable artificial kidney

• Four cycles an hour and every 8 hours patients change the filter.

• Electrolytes and glucose are added

• 6 pounds

• FDA approved – trials start in 2011

-belt

-batteries

-sterilizing filter

-pump

-valves and tubing

Works cited• Renal Physician's Association Working Committee on Clinical Practice Guidelines: Clinical

Practice Guideline on Adequacy of Hemodialysis. Clinical Practice Guideline #1. December 1993, Renal Physician's Association, Washington DC

• Hakim RM, Stannard D, Port FK, Held PJ: J Am Soc Nephrol 3:351, 1994

• ‘Blood Pressure Response during Hemodialysis”: The Effect of Amount of Replacement Fluid and Dialysate Temperature." Journal of the American Society of Nephrology. 1 Sept. 2001. Web. 10 Mar. 2011.

• http://www.homedialysis.org/

• http://www.dialysisfilterfyi.com/dialysisfilterworks.html

• http://www.organdonor.gov/student/access/organs.asp

• http://www.google.com/imgres?q=awak+vest