Definition:

The kidneys have an important role in maintaining health. When a person is healthy, his

kidneys maintain the body's internal equilibrium of water and minerals such as sodium,
potassium, chloride, calcium, phosphorus, magnesium and sulphate. The end-products of
digestion that the body has to get rid of are also excreted through the kidneys.
Kidney dialysis is the process of removing excess water, solutes, and toxins from blood for
people whose kidneys can no longer perform these functions naturally.
Dialysis is started when
1. The kidney stops functioning properly, in a condition known acute kidney injury or
acute renal failure
2. When a gradual decline in kidney function is observed, known as chronic kidney
disease, reaches stage 5. At this stage, the glomerulus only filters 10% of the waste
from blood, meaning, 90% of harmful toxins and waste materials continue circulating
throughout the body.

Process:
Dialysis can be performed in 2 ways:
Internally (Peritoneal Dialysis)
Externally (Hemodialysis)
In this project, we will be discussing how Hemodialysis is carried out:
What is the principle behind the process of Hemodialysis?
Dialysis works on the principle of the diffusion across a semi-permeable membrane.
According to the property of diffusion, substances in water tend to move from an area of high
concentration to an area of low concentration. Blood flows by one side of a semi-permeable
membrane, and a dialysing fluid, flows on the opposite side. A semipermeable membrane is a
thin layer of material that contains holes of various sizes. Smaller solutes and fluid pass
through the membrane, but it blocks the passage of larger substances such as red blood cells
and large proteins. This replicates the filtering process that takes place in glomerulus.
What is the setup for this process?
In Hemodialysis, the patient's blood is pumped through the blood compartment of a dialyzer,
exposing it to a partially permeable membrane. The dialyzer is composed of thousands of tiny
hollow synthetic fibres. The fibre wall acts as the semipermeable membrane. Blood flows
through the fibres, dialysis solution flows around the outside of the fibres, and water and
wastes move between these two solutions.[10] The cleansed blood is then returned via the
circuit back to the body.
History:
The first historical description of this type of procedure was published in 1913. Abel,
Rowntree, and Turner “dialyzed” anesthetized animals by directing their blood outside the
body and through tubes of semipermeable membranes made from Collodion, a material based
on cellulose.
In fall 1945, Willem Kolff, of the Netherlands, used a rotating drum kidney he had developed
to perform a week-long dialysis treatment on a 67-year-old patient who had been admitted to
hospital with acute kidney failure. The patient was subsequently discharged with normal
kidney function.
This patient proved that the concept developed by previous scientists could be put into
practice and thus represented the first major breakthrough in the treatment of patients with
kidney disease. The success was partially due to the technical improvements in the actual
equipment used for the treatment. Kolff’s rotating drum kidney used membranous tubes made
from a new cellulose-based material known as cellophane that was actually used in the
packaging of food.
During the treatment, the blood-filled tubes were wrapped around a wooden drum that rotated
through an electrolyte solution known as “dialysate.” As the membranous tubes passed
through the bath, the laws of physics caused the uremic toxins to pass into this rinsing liquid.

From that day onwards, numerous new changes and modifications have been made to these
machines, to make the procedure safe and comfortable for the patient, while increasing its
efficiency as well. Modern day dialysis is comparatively less time consuming, and most
patients simply have it done when they are asleep.
Disadvantages of Hemodialysis:
The procedure in a dialysis centre usually involves using a dialysis machine 3 times a week,
with each session usually lasting about 4 hours. A patient has to plan his life around these
sessions.

As the sessions are carried out in a dialysis clinic, he must travel regularly for treatment.

If a person is having treatment in a dialysis centre and they need travel to another country,
they will have to arrange access to dialysis facilities beforehand. Travel is restricted during
the procedure.

Another disadvantage of haemodialysis is that your diet and the amount of fluid you drink
needs to be restricted. Many people receiving haemodialysis in a dialysis centre have to avoid
certain foods and are usually advised not to drink more than a couple of cups of fluid a day.

A patient may also experience symptoms such as dizziness and nausea due to the procedure.