By Zachary Jacobson

First practiced on animals in early 1900’s

Developed by Dr. Willem Kolff in 1943

First successful treatment administered in 1945

In 1950’s Dr. Belding Scribner uses Teflon tubing Scribner heralded as father of

bioethics Scribner starts first

outpatient facility in 1962

Function of Kidneys Nephrons, glomeruli and waste tubules Hormone secretion support homeostasis

Causes of Chronic Kidney Disease/Failure Hypertension Diabetes mellitus (3 types)

Diagnosing KidneyDisease/Failure Elevated proteins and/or blood in urine

Function of Dialysis Filter waste and excess fluid from blood

Dialysis requires surgery to develop access site 3 types: fistula, graft, catheter

Filter Membrane Semi-permeable quality allows only smaller

materials(i.e. waste) to diffuse across Larger waste products and excess fluid require

ultrafiltration Dialysate

Composed of sterile water, electrolytes/chemicals and dextrose Dextrose concentration determines osmotic pressure

in PD exchange

Peritoneal Dialysis Creation of access site

Permenant Peritoneal Catheter Dialysate drawn into

abdominal cavity Peritoneum acts as filter

Waste stored in dialysate Dextrose level determines

ultrafiltration rate 2 types: CAPD, CCPD Dialysate drained from cavity

Hemodialysis Blood filtered outside of body

Dialyser Filters through synthetic

membrane Thousands of thin hollow fibers Countercurrent ultrafiltration Different types of filters

Dialysis Machine Monitors time, temp, pressure

Blood returned to body through access

PD vs. HD HD uses more predictable membrane PD is easier to use and more convenient PD less likely to cause Hypotension PD may cause trouble breathing

Dialysis patients require special diet and medication to replace hormonal function.

PD and HD do not replicate all kidney functions

Access sites can move or become infected

Limited movement Body image Time per treatment Blood clotting Expensive without health coverage

Shorter Dialysis Time Increased Efficiency in Filtration Increased Portability Recycling of Dialysate Simultaneous monitoring and

introduction of synthetic hormones

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