IST YEAR MSC. NURSING
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.
Historical Evolution in the Field Of
It was the romans first used a form of dialysis therapy
by using hot bath to patients to remove urea.
1854 the first time the term dialysis was used by
1889 BW Richardson First referred the use of
collodion membrane in the dialysis of blood .This
help the living animals were dialysed in
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.
1923 Heinrich Necheles was discovered
In mid 1930s purification of the heparin occur.
1937 an American scientist, William Thalhimer use first
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.
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.
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.
Principles of Dialysis
Diffusion: Diffusion is the movement of solutes from an area of
greater concentration to an area of lower concentration.
Osmosis: Osmosis is the movement of fluid from an
area of lesser concentration to an area of greater
concentration of solutes.
Ultra filtration: Ultra filtration that is solution move
when there is an osmotic gradient or pressure
gradient across the membrane.
INDICATION OF DIALYSIS
Severe electrolyte and/or fluid abnormalities
TYPES OF DIALYSIS
Psychosocial Issues in ESRD Patients
Psychological problems like,
Anxiety and behaviour disorders
Psychosocial Issues like,
Quality of life
Altered body image
Awareness of early death
Non adherence to the medical and nursing care
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-
Lewis, Dirksen, Heitkemper, Bucher “Medical – Surgical Nursing Assessment and
Management of Clinical Problems” (2011), 9th edition, Elsevier Publications, page no: 1183-
Lippincott “Manual of Nursing Practice” (2009), 10th edition, Wolters Kluwer (India)
publication, page no: 785-788