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The Effect Of Increasing Dialysate Flow Rate In Hemodialysis
تأثير زيادة معدل جريان سائل التحليل في عملية الغسل الكلوي الدموي (الديلزة)

Authors: Zainab Ismail Al-Salihi زينب اسماعيل احمد --- Dr. Sadiq Jafer Abbass صادق جعفر عباس
Journal: AL-NAHRAIN JOURNAL FOR ENGINEERING SCIENCES مجلة النهرين للعلوم الهندسية ISSN: 25219154 / eISSN 25219162 Year: 2007 Volume: 10 Issue: 1 Pages: 72-79
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Hemodialysis is a technique of removing, or clearing ,solutes from the blood and removal of extra fluid fromthe body, by using dialyzing machine and a dialyzerwhich is also known as (artificial kidney). The principleof hemodialysis is, primarily, the diffusion of solutesacross a semipermeable membrane and ultrafiltrationfor removal of extra fluid.The purpose of this study is to demonstrate the effect ofincreasing nominal dialysate flow rate from 500 ml/minto 800 ml/min on the amount of the small solutes (urea)removed from the blood and examine its effect on theamount of dialysis delivered.In this study the in vivo effects of increase in dialysateflow rate on the delivered dose of dialysis studied on 28maintenance hemodialysis patients.Hemodialysis was performed at dialysate flow rates 500and 800 ml/min. The patients treated two times per weekfor 3 hours. The results show increase in urea clearanceand dialysis adequacy, and a significant increase in theurea difference between pre- and post-blood ureaconcentration by increasing dialysate flow rate from 500to 800 ml/min.It can be concluded that hemodialysis with dialysateflow rate 800 ml/min should be considered in selectedpatients not achieving adequacy despite extendedtreatment times and optimized blood flow rate. Andincreasing nominal dialysate flow rate from 500 ml/minto 800 ml/min alters the mass transfer characteristics ofhollow fiber hemodialyzer and results in a largerincrease in urea clearance.

الديلزة هي إحدى التقنيات لإزالة أو تنظيف المواد المذابة في الدم، وأيضاً إزالة السوائل الزائدة من الجسم، باستخدام جهاز التحليل والمحلل والذي يعرف أيضاً بـ(الكلية الصناعية). إن مبدأ الديلزة يعتمد في الأساس على انتشار المواد المذابة عبر غشاء ذو نصف نفاذية والترشيح الفائق لإزالة السوائل الزائدة.عند الغسل الكلوي الدموي (الديلزة)، يُضخ الدم من الجسم إلى مرشح خاص (المحلل) مكون من أنابيب شعرية بلاستيكية صغيرة جداً. يتم تنقية الدم عند انتشار المكونات المهملة من الدم عبر غشاء الأنابيب الشعرية إلى سائل الديلزة. ويعاد الدم المنقى ثانية إلى الجسم والسائل المستهلك يتم صرفه.تهدف هذه الدراسة لبيان تأثير زيادة معدل تدفق سائل الديلزة من 500 مليلتر/دقيقة إلى 800 مليلتر/دقيقة على مقدار المواد المذابة الصغيرة (اليوريا) التي أزيلت من الدم، وفحص ودراسة هذا التأثير على كمية الغسل الكلوي (الديلزة) الموفرة للمريض.تم في هذا البحث دراسة التأثيرات داخل الجسم عند زيادة معدل تدفق السائل على كمية الغسل الممنوحة لثمانية وعشرين مريضاً معتمدين على الكلية الصناعية، حيث تم التحليل لمعدلات تدفق 500 و 800 مليلتر/دقيقة. أظهرت النتائج زيادة في إزالة اليوريا وعلى كمية الديلزة المستفادة من قبل المريض. ووجود زيادة ملحوظة في فرق التركيز لليوريا في الدم قبل وبعد الغسل الكلوي الدموي عند زيادة معدل تدفق سائل الديلزة من 500 إلى 800 مليلتر/دقيقة.يستنتج من ذلك، ان عملية الغسل الكلوي الدموي (الديلزة) بمعدل تدفق سائل الديلزة 800 مليلتر/دقيقة يجب اعتباره في المرضى الذين لم يحصلوا على الغسل الكلوي الكافي بالرغم من علاج زمني مستمر ذو معدلات تدفق دم فضلى، وأن زيادة معدل تدفق سائل الديلزة من 500 إلى 800 مليلتر/دقيقة يغير خصائص إنتقال المواد في جهاز التحليل (المحلل) وينتج زيادة أكبر في التخلص من اليوريا.

Keywords

Biomechanics --- Hemodialysis --- kidney --- dialysate


Article
Asymptomatic Hypoglycemia After Hemodialysis in Non-Diabetic Patients with Use of Glucose- Free Dialysate Solutions

Authors: Ahmed Hussein Jasim --- Haider Mehdi Mueen --- Ameer Ahmed Aljubawii
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 107-115
Publisher: Babylon University جامعة بابل

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Abstract

Hypoglycemia (HG) has been demonstrated during chronic hemodialysis (HD). These events may become more frequent with the current use of glucose-free bicarbonate dialysis solution, the standard formula in most dialysis units in our hospitals. The Aim of study is to evaluate the occurrence of HG in non-diabetic (NDM) end-stage renal failure patients during HD using dialytic solution without glucose. In Merjan teaching hospital from January to September 2013. A hospital-based cross-sectional study design has been carried out on fifty non-diabetic patients with chronic renal failure randomly selected from the dialysis unit of Merjan Teaching Hospital after their setting for HD session of the glucose- free bicarbonate solution. Serum glucose has been measured at zero hour before dialysis session and 30 minutes after dialysis session. The study duration was from January to September 2013 Categorical variables were presented as frequencies and percentages. Continuous variables were presented as means with their 95% confidence interval (CI) and standard deviation. The Pearson's chi-square test (x2) was used to determine the associations between categorical variables. Independent sample t-test was used to compare between two means. A p-value of < 0.05 was considered as statistically significant.Data were expressed No patient presented any clinical evidence of HG.40 patients(74.8%) of fifty patients express serum sugar levels changes before and after HD ,serum sugar levels after HD was <80mg/dl ,which is statistically significant P value <0.01.Asymptomatic HG was frequent during HD when glucose-free dialysis solution was used. Glucose added dialysis solution at 90 mg/dl significantly reduced the number and severity of HG episodes and although it caused higher mean glycaemia in DM patients during HD, its use seems advisable in all patients.


Article
EFFECT OF DIALYSATE TEMPERATURE ON HEMODYNAMIC STABILITY AMONG HEMODIALYSIS PATIENTS

Authors: Tarik A. Hussein طارق حسين --- Arif S. Malik عارف سامي مالك
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 2 Pages: 173-179
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Hypotension is one of the complications of hemodialysis treatment. It increases morbidity and mortality and can compromise the dialysis efficacy. Cooling the dialysate below 36.5°C is an important factor that contributes to hemodynamic stability in patients during hemodialysis.Objective:To assess the effect of dialysate temperature on hemodynamic stability during hemodialysis sessions, post dialysis fatigue and the adequacy of dialysis.Methods:A total of 40 patients were assessed during six dialysis sessions; in three sessions, the dialysate temperature was (37 °C) and in three other sessions, the dialysate temperature was (35 °C). Specific scale questionnaires were used in each dialysis session, to evaluate the symptoms during the dialysis procedure as well as post-dialysis fatigue, and respective scores were noted. Blood pressure, heart rate, temperature were recorded. Also dialysis efficacy using Kt/v, urea reduction ratio were measured.Results:The results showed that usage of low dialysate temperature was associated with the following : higher post dialysis systolic blood pressure (P < 0.05) and lower post dialysis heart rate (P < 0.05), better intra-dialysis symptoms score and post-dialysis fatigue scores (P < 0.05 and P < 0.05, respectively), shorter post-dialysis fatigue period (P < 0.05) as well as Similar urea removal and Kt/V .Conclusion:Cool dialysis is an important factor in hemodynamic stability during hemodialysis. Also it improves symptoms during and after hemodialysis. Cool dialysis has no effect on adequacy of dialysis.Key words:Hemodialysis, Cool dialysate, Hypotension, Hemodynamic

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