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Hemodialysis and peritoneal dialysis

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Hemodialysis and peritoneal dialysis

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Hemodialysis and peritoneal dialysis

  1. 1. DIALYSIS ANEEZ. K IST YEAR MSC. NURSING EMS CON
  2. 2. Definition Dialysis is the movement of fluid and molecules across a semipermeable membrane from one compartment to another. Clinically dialysis is a technique in which substances move from the blood through a semipermeable membrane and in to a dialysis solution called dialysate.
  3. 3. Historical Evolution in the Field Of Dialysis  It was the romans first used a form of dialysis therapy by using hot bath to patients to remove urea.
  4. 4.  1854 the first time the term dialysis was used by Thomas Graham  1889 BW Richardson First referred the use of collodion membrane in the dialysis of blood .This help the living animals were dialysed in experimental conditions.
  5. 5.  1914 Hess & McGuigan were experimenting with dialysis in a pharmacology lab in Chicago. As a result they were able to transfer sugar from tissue to blood and from the blood across a collodion membrane.  1920s the first dialysis performed on human was carried out by George Hass. He used hirudin as an anticoagulant and later a crude form of heparin. He was honoured as a pioneer of dialysis.
  6. 6.  1923 Heinrich Necheles was discovered contemporary dialyser.  In mid 1930s purification of the heparin occur.  1937 an American scientist, William Thalhimer use first synthetic membrane.
  7. 7.  In 1945 William Kolff first clinical experience was gained on a 29 year old women with chronic nephritis. The blood urea was kept stable for 26 days but after 12 sessions of dialysis her blood urea began to increase and she subsequently died.  After the world war Kolff technique was wildly used.
  8. 8.  In 1950s Allis Chalmers Corporation was one of the first companies to produce dialysis machine commercially.  In the late 1950s Fredrik Kiil of Norway made more modification in the field of dialyser.  In 1960s the forerunner of today’s capillary – flow dialyser was produced by Richard Stewart.  Belding Scribner was introduced the shunt to provide vascular access in dialysis.
  9. 9.  Followed by this invention hemodialysis started.  In late 1970s and early 1980s the continuous ambulatory peritoneal dialysis as the first choice of home treatment.  The innovations in the field of dialysis is reaching up to the satellite dialysing unit nowadays. And the patient surveillance rate also increase.
  10. 10. Principles of Dialysis  Diffusion: Diffusion is the movement of solutes from an area of greater concentration to an area of lower concentration.
  11. 11.  Osmosis: Osmosis is the movement of fluid from an area of lesser concentration to an area of greater concentration of solutes.
  12. 12.  Ultra filtration: Ultra filtration that is solution move when there is an osmotic gradient or pressure gradient across the membrane.
  13. 13. INDICATION OF DIALYSIS  Renal failure  Severe electrolyte and/or fluid abnormalities  Acidosis  Drug overdose  Poisoning
  14. 14. TYPES OF DIALYSIS  HEMODIALYSIS  PERITONEAL DIALYSIS
  15. 15. HEMODIALYSIS  HEMODIALYSIS APPARATUS Blood circuit Dialysis solution circuit Dialyser
  16. 16. BLOOD CIRCUTE
  17. 17. DIALYSIS SOLUTION CIRCUTE  Water Purification System RO + Acetic Acid + NaHCO3 + KHCO3
  18. 18. REVERSE OSMOSIS
  19. 19. DIALYSER
  20. 20. VASCULAR ACCESS  Intravenous Catheter Non-tunnelled or Temporary Catheter Tunnelled or Permanent Catheter or Prem Cath  AV fistula  AV graft
  21. 21. INTRAVENOUS CATHETERS
  22. 22. Replacement therapies of HD  HEMOFILTRATION  HEMODIAFILTRATION  INTESTINAL DIALYSIS  PLASMAFERESIS
  23. 23. PERITONEAL DIALYSIS  Fill phase  Dwell phase  Drain phase
  24. 24. Complications of Peritoneal Dialysis Peritonitis Catheter Infection Cuff erosion Abdominal hernias Abdominal distension Hypotension
  25. 25. Hyperglycaemia Hypernatremia/ Hypernatremia Hyperkalaemia/Hypokalaemia Hypoalbuminemia Abdominal wall and pericatheer leak Genital edema Respiratory complications Back pain Dyslipidaemia
  26. 26. Psychosocial Issues in ESRD Patients Psychological problems like, Depression Dementia/ Delirium Anxiety and behaviour disorders
  27. 27. Psychosocial Issues like, Marital relationship Sexual dysfunction Socioeconomic issues Rehabilitation Quality of life Altered body image Awareness of early death Non adherence to the medical and nursing care
  28. 28. BIBLIOGRAPHY  John T. Daugirdas, Peter G. Blake, Todd S. Ing “Handbook of Dialysis”(2007),4th edition, Wolters Kluwer (India) publication, page no: 59-88  Allen R. Nissenson, Richrad N. Fine “Handbook of Dialysis Therapy” (2009), 4th edition, Elsevier Publications, page no: 703-710, 1221-1225  Nicola Thomas “Renal Nursing” (2008), 3rd edition, Elsevier Publication, page no: 73-78, 181- 232  Lewis, Dirksen, Heitkemper, Bucher “Medical – Surgical Nursing Assessment and Management of Clinical Problems” (2011), 9th edition, Elsevier Publications, page no: 1183- 1188  Lippincott “Manual of Nursing Practice” (2009), 10th edition, Wolters Kluwer (India) publication, page no: 785-788  http://en.wikipedia.org/wiki/Dialysis  http://www.ncbi.nlm.nih.gov/pubmed/22916962

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