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Mohammed Abdel Gawad MD/PhD Neph, ESENeph
Nephrology Unit, School of Medicine, NewGiza University
Nephrology Consultant, Alexandria
Founder of NephroTube.com
Chair of AFRAN Web/Media Committee
ISN Education SoMe Team Member
Chapter 1
Physiological Principles of
Hemodialysis
You can get this book free from www.NephroTube.com
Visit
www.NephroTube.com
to watch the video recording of this
lecture and
to get more Nephrology lectures
NephroTube YouTube channel
www.YouTube.com/NephroTube
Dialyzer
Blood
compartment
Dialysate
compartment
Semipermeable membrane
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
A B
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
A B
The rate of diffusion of a molecule through a semipermeable membrane is
inversely proportional to its size.
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Blood Dialysate
Creatinine
Urea
Na+
K+
Ca2+
HCO3
-
Creatinine
Urea
Na+
K+
Ca2+
HCO3
-
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Blood in
Dialysate in
Dialysate
effluent pump
Positive
pressure
Negative
pressure
Water movement
(Ultrafiltration)
Dialysate out
Blood out
Adjustable inflow
resistance by
clamp
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Blood Dialysate
Positive
pressure
Negative
pressure
Blood Dialysate
Positive
pressure
Negative
pressure
Water movement
(Ultrafiltration)
Solutes move
with water
(Solvent Drag)
A B
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Factors affecting convective transport:
1. Sieving coefficient of the membrane
(SC)
2. Solute size.
3. Transmembrane pressure (TMP) and
ultrafiltration (UF) volume.
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Factors affecting convective transport:
1. Sieving coefficient of the membrane
(SC)
2. Solute size.
3. Transmembrane pressure (TMP) and
ultrafiltration (UF) volume.
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Diffusion versus ultrafiltration and convection
in hemodialysis
• In hemodialysis, diffusion is the predominant method of solute clearance.
• In hemodialysis, there is a very small volume of ultrafiltration required to remove the
excess fluid volume gained between dialysis sessions. This means that the solute clearance
by convection is small.
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Dialyzer
Blood in
Dialysate in
Dialysate out with
small volume of UF
Blood out
Hemodialysis
Dialyzer
Blood in
Large volume
of UF out
Blood out
Hemofiltration
Pre-dialyzer
replacement fluid
Post-dialyzer
replacement fluid
Dialyzer
Blood in
Dialysate in
Blood out
Hemodiafiltration
Dialysate out with
large volume of UF
Dialyzer
Blood in
Slow rate
of UF out
Blood out
Isolated ultrafiltration
Pre-dialyzer
replacement fluid
Post-dialyzer
replacement fluid
A B
C D
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Talk Outline: Chapter 1
Physiological Principles of Hemodialysis
• Physiological principles (mechanisms) of solutes and water transport:
I. Diffusion
II. Ultrafiltration
III. Convection (solvent drag)
• Diffusion versus ultrafiltration and convection in hemodialysis
• Other different techniques of blood-based dialysis therapies rather
than hemodialysis
• Different modalities of blood-based kidney replacement therapy
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
- HD, HF, HDF, and isolated ultrafiltration can be performed in the form of IKRT, PIKRT, or CKRT.
- Online-HDF (ol-HDF) is a form of IKRT.
NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024
You can get this book free from www.NephroTube.com
Thank You

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Hemodialysis: Chapter 1, Physiological Principles of Hemodialysis - Dr.Gawad

  • 1. Mohammed Abdel Gawad MD/PhD Neph, ESENeph Nephrology Unit, School of Medicine, NewGiza University Nephrology Consultant, Alexandria Founder of NephroTube.com Chair of AFRAN Web/Media Committee ISN Education SoMe Team Member Chapter 1 Physiological Principles of Hemodialysis You can get this book free from www.NephroTube.com
  • 2. Visit www.NephroTube.com to watch the video recording of this lecture and to get more Nephrology lectures
  • 4. Dialyzer Blood compartment Dialysate compartment Semipermeable membrane NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 5. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 6. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 7. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 8. A B NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 9. A B The rate of diffusion of a molecule through a semipermeable membrane is inversely proportional to its size. NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 10. Blood Dialysate Creatinine Urea Na+ K+ Ca2+ HCO3 - Creatinine Urea Na+ K+ Ca2+ HCO3 - NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 11. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 12. Blood in Dialysate in Dialysate effluent pump Positive pressure Negative pressure Water movement (Ultrafiltration) Dialysate out Blood out Adjustable inflow resistance by clamp NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 13. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 14. Blood Dialysate Positive pressure Negative pressure Blood Dialysate Positive pressure Negative pressure Water movement (Ultrafiltration) Solutes move with water (Solvent Drag) A B NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 15. Factors affecting convective transport: 1. Sieving coefficient of the membrane (SC) 2. Solute size. 3. Transmembrane pressure (TMP) and ultrafiltration (UF) volume. NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 16. Factors affecting convective transport: 1. Sieving coefficient of the membrane (SC) 2. Solute size. 3. Transmembrane pressure (TMP) and ultrafiltration (UF) volume. NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 17. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 18. Diffusion versus ultrafiltration and convection in hemodialysis • In hemodialysis, diffusion is the predominant method of solute clearance. • In hemodialysis, there is a very small volume of ultrafiltration required to remove the excess fluid volume gained between dialysis sessions. This means that the solute clearance by convection is small. NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 19. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 20. Dialyzer Blood in Dialysate in Dialysate out with small volume of UF Blood out Hemodialysis Dialyzer Blood in Large volume of UF out Blood out Hemofiltration Pre-dialyzer replacement fluid Post-dialyzer replacement fluid Dialyzer Blood in Dialysate in Blood out Hemodiafiltration Dialysate out with large volume of UF Dialyzer Blood in Slow rate of UF out Blood out Isolated ultrafiltration Pre-dialyzer replacement fluid Post-dialyzer replacement fluid A B C D NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 21.
  • 22. Talk Outline: Chapter 1 Physiological Principles of Hemodialysis • Physiological principles (mechanisms) of solutes and water transport: I. Diffusion II. Ultrafiltration III. Convection (solvent drag) • Diffusion versus ultrafiltration and convection in hemodialysis • Other different techniques of blood-based dialysis therapies rather than hemodialysis • Different modalities of blood-based kidney replacement therapy NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com
  • 23. - HD, HF, HDF, and isolated ultrafiltration can be performed in the form of IKRT, PIKRT, or CKRT. - Online-HDF (ol-HDF) is a form of IKRT. NephroTube Synopsis of Conventional Hemodialysis, First Edition, 2024 You can get this book free from www.NephroTube.com