- Dialysis is a process that uses a semi-permeable membrane to remove waste and excess fluid from the blood through diffusion, convection, osmosis and ultrafiltration when the kidneys are failing. - There are two main types of dialysis: hemodialysis which uses a machine to filter the blood outside of the body, and peritoneal dialysis which uses the peritoneal membrane in the abdomen to filter blood inside the body. - Dialysis is indicated for acute or chronic renal failure to control symptoms like fluid overload, electrolyte imbalances, and uremia when the kidneys are no longer able to sufficiently perform their functions.

1. BASICS OF DIALYSIS
DR.MAHESWARI JAIKUMAR
maheswarijaikumar2103@gmail.com

2. DIALYSIS
• Dialysis is the process by which the
solute composition of a solution “A”
is altered by exposing it to a second
solution “B” through a semi-
permeable membrane

3. PRE REQUISITES OF HEMO
DIALYSIS
• Semi-permeable membrane
• Anticoagulation
• Knowing what to remove and
how much of it

4. MECHANISM OF SOLUTE
TRANSFER
• DIFFUSION
• CONVECTION
• OSMOSIS
• ULTRAFILTERATION

5. SOLUTE
• A solution is a special type of
homogeneous mixture composed of
two or more substances. In such a
mixture, a solute is a substance
dissolved in another substance,
known as a solvent.

6. DIFFUSION
• Diffusion is the net movement of
anything from a region of higher
concentration to a region of lower
concentration. Diffusion is driven by a
gradient in concentration.
• The concept of diffusion is widely used
in many fields, including physics,
chemistry, biology, sociology,
economics, and finance.

8. DIFFUSION

9. OSMOSIS
• Osmosis is the spontaneous net
movement of solvent molecules
through a selectively permeable
membrane into a region of higher
solute concentration, in the
direction that tends to equalize the
solute concentrations on the two
sides.

10. OSMOSIS

11. REVERSE OSMOSIS
• Reverse osmosis (RO) is a water
purification process that uses a
partially permeable membrane to
remove ions, unwanted molecules
and larger particles from drinking
water. ... The process is similar to
other membrane technology
applications.

12. ULTRA FILTERATION
• Ultrafiltration (UF) is a membrane
filtration process similar to Reverse
Osmosis, using hydrostatic pressure
to force water through a semi-
permeable membrane. The pore
size of the ultrafiltration membrane
is usually 103 - 106 Daltons.

13. • In renal physiology, ultrafiltration
occurs at the barrier between the
blood and the filtrate in the
glomerular capsule in the kidneys.
As in nonbiological examples of
ultrafiltration, pressure and
concentration gradients lead to a
separation through a
semipermeable membrane

14. CONVECTION
• The movement caused within a fluid by
the tendency of hotter and therefore
less dense material to rise, and colder,
denser material to sink under the
influence of gravity, which consequently
results in transfer of heat.
• "the final transfer of energy to the
surface is by convection"

15. DIFFUSIVE CLEARANCE
• A result of random molecular
motion
• influenced by concentration
gradient of the solute and its
Molecular weight as well as by the
membrane permeability to the
solute

16. CONVECTIVE CLEARANCE
• Water molecules passing through a SPM
carry with them the solutes in their original
concentration. This is called the “solvent drag
phenomenon”
• Water can be made to move across a SPM by
the application of either a hydrostatic or an
Osmotic gradient

19. TYPES OF DIALYSIS
• There are two main types of
dialysis,
• HEMODIALYSIS
• PERITONEAL DIALYSIS.

20. HEMODIALYSIS
• Hemodialysis uses a machine
and a filter to remove waste
products and water from the
blood.

21. SCHEMATIC REPRESENTATION
OF HEMO DIALYSIS

22. PERITONEAL DIALYSIS
Peritoneal dialysis uses a fluid
(dialysate) that is placed into the
patient's abdominal cavity to
remove waste products and fluid
from the body.

23. PERITONEAL DIALYSIS

24. DIALYSATE
• Dialysate, also called dialysis fluid,
dialysis solution or bath, is a
solution of pure water, electrolytes
and salts, such as bicarbonate and
sodium.
• The purpose of dialysate is to pull
toxins from the blood into
the dialysate. The way this works is
through a process called diffusion.

26. INDICATIONS FOR DIALYSIS –
ACUTE RENAL FAILURE
• Severe fluid overload
• Refractory hypertension
• Uncontrollable hyperkalemia
• Nausea, vomiting, poor appetite,
gastritis with hemorrhage

27. • Lethargy, malaise, somnolence, stupor,
coma, delirium, asterixis, tremor,
seizures,
• Pericarditis (risk of hemorrhage or
tamponade)
• bleeding diathesis (epistaxis,
gastrointestinal (GI) bleeding and etc.)
• Severe metabolic acidosis
• Blood urea nitrogen (BUN) > 70–100
mg/d

28. INDICATIONS FOR DIALYSIS :
CHRONIC RENAL FAILURE
• Pericarditis
• Fluid overload or pulmonary edema
refractory to diuretics

29. • Accelerated hypertension poorly
responsive to antihypertensives
• Progressive uremic encephalopathy
or neuropathy such as confusion,
asterixis, myoclonus, wrist or foot
drop, seizures
• Bleeding diathesis attributable to
uremia

30. MNEMONIC IS USED TO
REMEMBER THE INDICATIONS FOR
DIALYSIS: A-E-I-O-U.
Dialysis: Indications ---------AEIOU:
Acid-base problems
Electrolyte problems
Intoxications
Overload, fluid
Uremic symptoms

31. COMPLICATIONS OF DIALYSIS
• Hypotension (Low blood pressure) This is
related to the speed and amount of fluid
removed from your blood. ...
• Fluid Overload. Between sessions, patients
can some times develop a condition called
fluid overload
• Bleeding From Access Point
• INFECTION
• High Potassium

32. THANK YOU