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How does dialysis work - main principle of dialysis
The main principle
A separation and purification technique that separates small molecules from biological macromolecules through the principle of diffusion of small molecules into water (or buffers) through semipermeable membranes.
Collapse the scope of application of this paragraph
A method of treating a component (solute or moisture) in body fluid through a semi-permeable membrane. Commonly used in cases of acute or chronic renal failure, drug or other poisons accumulate in the body. The commonly used dialysis methods are hemodialysis and peritoneal dialysis.
The patient’s blood and dialysate are introduced into the dialyzer at the same time (the flow direction of the two is opposite), and the semi-permeable membrane of the dialyzer (artificial kidney) is used to remove excessive toxins and excess water accumulated in the blood from the body. Bases are supplemented to correct acidosis, regulate electrolyte imbalances, and replace renal excretion.
Blood dialyzer commonly known as artificial kidney, hollow fiber type, coil type and flat type 3 kinds. The most commonly used hollow fiber type is composed of 1 to 15,000 hollow fibers. The wall of the hollow fiber is the dialysis membrane and has the characteristics of semi-permeable membrane. During hemodialysis, blood flows into each hollow fiber, and the dialysate flows through each hollow fiber. The flow direction of the blood is opposite to the flow direction of the dialysate. The poison is removed through the semi-permeable membrane principle and the water is removed through ultrafiltration and permeation.
Indications and contraindications
The indications for hemodialysis include: 1 Acute renal failure. 2 acute drug or poison poisoning. 3 chronic renal failure. 4 Renal failure before renal transplantation or rejection after transplantation makes the transplanted kidney incompetent. 5 other diseases (liver failure, schizophrenia, psoriasis, etc.).
The relative contraindications for hemodialysis include: 1 The condition is extremely critical, hypotension, and shock. 2 Severe infection with sepsis. 3 severe myocardial insufficiency or coronary heart disease. 4 within 3 days after major surgery. 5 severe bleeding tendency, cerebral hemorrhage and severe anemia. 6 mentally uncooperative. 7 Malignant tumor patients.
The average patient needs hemodialysis three times per week for 4 to 5 hours each time. People should start dialysis early. So it can correct irreversible organ damage caused by excessive accumulation of toxins and metabolic disorders of the body. Dialysis should be started when creatinine clearance is reduced to 10-12 mL/min. 15 to 60-year-old patients have good dialysis and safety, but due to continuous improvement of dialysis technology and the continuous emergence of new dialysis equipment, patients over the age of 70 can also get good results.
In order to ensure the quality of life of dialysis patients and improve the recovery rate, hemodialysis patients should ensure daily intake of protein 1.0 ~ 1.2 g / kg and 146.3 kJ / kg, and should take sufficient water-soluble vitamins and trace elements to supplement dialysis Lost volume. The 5-year survival rate of dialysis patients varies from country to country, about 50% to 80%, and 10-year survival rates exceeding 50% have also been reported.