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Blood purification treatments

What is blood purification treatment?

Blood purification is generally known as dialysis. Blood purification treatments are to guide the blood out of the body through purification equipments. The pathogenic materials in the blood would be filtered by the purification equipment in order to achieve the effect of treating diseases.

Blood purification treatments include hemodialysis, hemofiltration, hemoperfusion, plasma exchange, immune adsorption.0.jpg

Hemodialysis:

What is hemodialysis?

Hemodialysis is one of the renal replacement therapies for treating both active and chronic renal failure. During the course of hemodialysis, the blood of the patients is guided out of the body and flow through the dialysis equipment which consists of countless hollow fibers. The wasted products in the blood will be purified and both the electrolyte balance and acid base balance are maintained; redundant water will also be excreted out of the body.

Procedure of hemodialysis:

1 Because hypertension would damage renal function, patient’s blood pressure should be carefully monitored prior to hemodialysis to defer the occurrence of renal failure and the complications of cardiovascular.

2 As hemodialysis starts, hemodialysis machine pumps the patient's blood and the dialysate through the dialyzer. After the countercurrent exchange between blood and dialysate, the used dialysate will be pumped into the waste liquid groove while the blood will be pumped back to the patient so as to clean the blood of the patient.

Advantages and disadvantages:

Advantages: low mortality rate

Better control of blood pressure

Less diet restriction

Disadvantages: People undergoing hemodialysis could not move around.

Care giver has to have more knowledge as the procedure of

hemodialysis is complicated.

Side effects and complications

Hemodialysis often requires fluid removal as most patients with renal failure have little or no urine. However too much fluid or too rapid fluid

will cause such side effects as low blood pressure, fatigue, chest pain, leg-cramps, nausea and headaches.

Hemofiltration

What is hemofiltration?

Hemofiltration refers to a renal replacement treatment similar to hemodialysis which is used almost exclusively in the ICU. Thus, it is mainly used for acute renal failure. Hemofiltration is a slow and continuous treatment, the session of which usually last from 12 hours up to 24 hours. During hemofiltration, the patient’s blood is pumped through a set of tubing by a machine to a semi permeable membrane, there, waste products and excessive water are removed out of the blood.

The principle of hemofiltration:

Different from dialysis, solute movement with hemofiltration is conducted by convection rather than by diffusion. During hemofiltration, a positive hydrostatic pressure drives water and solutes across the filter membrane from blood compartment to the filtrate compartment without the usage of dialysate. With the application of hydrostatic pressure, large amount of fluid that consists of body fluids and solutes is removed and a replacement fluid is then added to the blood to replace the body fluid and electrolytes.

What are the functions of hemofiltration?

Remove both small-sized and medium-sized wastes in the blood.

Remove a variety of large-sized toxin substances in the blood.

Controlling of inflammations

The main difference between hemofiltration and hemodialysis

During hemodialysis, solutes is removed and cleaned through dispersion caused by concentration difference of solutes in both sides of the semi permeable membrane. The efficacy of hemodialysis depends on degree of dispersion and the efficacy of hemodialysis changes with the amount of molecule; the larger the amount of molecule is the lower efficacy of hemodialysis will be. While in hemofiltration, even the substance with large amount of molecule could be removed by hydrostatic pressure. Hemofiltration imitates the function of glomerulus so that the efficacy of which is similar to that of glomerulus, better than hemodialysis.

Side effects of hemofiltration

Muscle cramps

Itching,

Sleep problem,

Anemia

Depression

Bone disease

Infection

Plasma exchange

What is plasma exchange?

Plasma exchange (PE), which is also known as plasmapheresis, is the removal, treatment and return of blood plasma from blood circulation. During plasma exchange, the blood of the patient is led into a plasma exchange device where the separated plasma is removed and fresh plasma is replaced so as to clean and remove the immune complex and some kinds of antibodies from blood.

What are the functions of plasma exchange?

1PE is capable of rapidly and effectively removing the factors relevant to diseases including antibodies, immune complexes or changing the ratio of antigens to antibodies. PE is more rapid and more effective than immunosuppressive agents in removal of diseases factors.

2PE is able to reduce the amount of inflammatory mediators including complement products and the concentration of fibrinogen in plasma so as to improve the relevant symptoms.

3 Strengthen the phagocyte to improve immunity of the patients.

What are the side effects of Plasma exchange?

Hypocalcemia may appear accompanied by symptoms including numbness, muscle spasm and arrhythmia.

Bleeding

Infection and virus infection

Anaphylactic reaction including shivering, rash, fever and hypotension

Hypokalemia

PE may reduce the plasma concentration of some kinds of drugs.

Hemoperfusion

What is hemoperfusion?

Hemoperfusion is a treatment technique through which a large volume of the blood of the patient is passed over an adsorbent device so as to remove the toxic substances in the blood. Hemoperfusion is able to remove all small- and medium-sized toxic substances as well as some large wasted products in the blood.

What are the functions of hemoperfusion?

Remove a variety of drugs and creatinine, uric acid, organic acid, etc in blood.

Provide patients with supportive treatment prior to or after renal transplantation.

It has better efficacy in removing some specific wasted products which are related to proteins in the blood.

What are the side effects of hemoperfusion?

Infection and virus infection

Hypotension

Blood clotting

Reduction in blood platelets

Article by : Treatment of kidney failure

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