Basic fundamentals of dialysis
Khullar, Dinesh (2002) Basic fundamentals of dialysis. JIMSA, 15 (3). pp. 163-169.
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Dialysis is a process whereby the composition of a solution Is altered by exposing it to another solution across a semi-permeable membrane which allows the passage of low molecular weight solutes only. The proems involves the physiologic principles of diffusion and ultraflltration. Clinically, the dialysis is of two main types. The first one I.e. hemodialysls employs the use of a machine and a dialyzer which consists of a. semi-permeable membrane across which, the exchange of solutes takes place. The process requires blood to be withdrawn from the body via specially designed vascular access and this is then passed through a machine circuit, purified and then returned to the body. Based on the various parameters the idea Is to ensure delivery of an adequate dialysis dosage. The other form of dialysis is the peritoneal dialysis. Here the exchange between solutes takes place between the blood in the peritoneal capillaries and the dialysis solution in the peritoneal cavity across the peritoneal membrane. A special type of catheter Is surgically placed in the peritoneal cavity and exchanges with a special type of fluid carried out on a dally basis. Most commonly the patient is put on CAPD I.e. continuous ambulatory peritoneal dialysis whereby patients peritoneal cavity at all times contains dialysis fluid whic>* Is changed at fixed intervals thus ensuring continuous dUriysIs while in between the exchanges, the patient Is ambulatory.
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