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In
medicine, dialysis is primarily used to provide an artificial
replacement for lost kidney function (renal replacement therapy) due to
renal failure.
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There
are two primary types of dialysis, hemodialysis and peritoneal dialysis.
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In
hemodialysis, the patient's blood is pumped through the blood
compartment of a dialyzer, exposing it to a semipermeable membrane. The
cleansed blood is then returned via the circuit back to the body.
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In the
US, hemodialysis treatments are typically given in a dialysis center
three times per week. People in the US are dialyzing at home more
frequently for various treatment lengths.
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In
peritoneal dialysis, a sterile solution containing minerals and glucose
is run through a tube into the peritoneal cavity, the abdominal body
cavity around the intestine, where the peritoneal membrane acts as a
semipermeable membrane. The dialysate is left there for a period of time
to absorb waste products, and then it is drained out through the tube
and discarded.
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Hemofiltration is a similar treatment to hemodialysis, but it makes use
of a different principle. Hemodiafiltration is a term used to describe
several methods of combining hemodialysis and hemofiltration in one
process.
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The
term high flux dialysis refers to a form of hemodialysis that was
developed in recent years to improve the efficiency of dialysis. It has
succeeded in both improving the quality of dialysis and in shortening
dialysis times.
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Nephrologists typically use some form of the technique called urea
kinetic modeling to determine their dialysis prescription. Using
national standards for adequacy of dialysis, and after taking residual
renal function into account, urea kinetic modeling uses the dialyzer’s
performance characteristics and the patient’s weight to derive an
estimate of the time required for dialysis.
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A
company from Oregon is using an emerging microtechnology from Oregon
State University to develop a portable kidney dialysis machine that will
make in-home treatment a reality, enabling hundreds of thousands of
people afflicted with kidney failure to treat themselves at home instead
of traveling to dialysis clinics three days a week.
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Dialysis patients are prescribed, on averaged, 10 to 14 medications,
leading to complicated dosing regimens. Severe renal dysfunction
predisposes to altered drug elimination and metabolism, which may be
further complicated by continuous or intermittent dialytic procedures.
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