Dialysis in Nursing

[Dialysis (physics)]

Dialysis is a chemical-physical which separates one or more substances dissolved in a liquid , using a semi-permeable membrane that allows the passage of these substances in one direction.

The movement of such substances is diffuse , or is due mainly to the difference in concentration of solutes in the solvents in the two compartments and ceases once you reach equilibrium. Between solvents and solutes is important the contribution of the osmotic pressure (see Osmosis ). Another factor that can influence the movement of substances is given by the gradient of pressure between the two sectors, provided it is acceptable (or even acceptable, as in the case of hemodialysis ) the transit of a certain amount of solvent from the fund subject at higher pressure than the other: in these conditions the movement of solutes is also convection .

Hemodialysis is a physical therapy replacement function impairment administered to subjects in which it is critically reduced ( uremia ), a condition that represents the most severe stage of ' renal failure .

• The procedure replaces the four basic functions of the kidney:
• removal of toxic substances
• electrolyte balance
• acid-base balance
• fluid removal

Hemodialysis the first two functions are carried out by subjecting the blood of the patient (hence emo) to the physical principle of dialysis , it is slipped into a filter where it comes into contact with a semi permeable membrane ( dialysis ), through which pass only ( or at least as much) are toxic substances that you want to remove. This filter is used in addition to the removal of substances including the reinstatement of the alkali radicals, then the acid-base balance. The last function listed on the need to remove the liquid entered through the power or eliminated with the urine that can be extremely reduced or absent ( anuria ) in subjects with end-stage kidney disease. The method used is the ultrafiltration .

Grips and returning the blood

There are two distinct groups of dialysis techniques:
hemodialysis, blood is extracted from the patient, filtered through a semipermeable membrane and reinfused
the peritoneal dialysis you enter (several times a day) of fluid in the peritoneal cavity using the peritoneum (thin membrane that surrounds the abdominal organs) as a semi-permeable membrane to perform processes on the cited

Each of the two groups comprise different methods, the most common subtypes of hemodialysis are:
• Standard hemodialysis (ED)
• Hemofiltration in pre-and post-dilution (HF)
• Hemodiafiltration (HDF)
• Online hemodiafiltration (HDF On Line)
• Acetate-Free Biofiltration (AFB)
• Paired Filtration Dialysis (PFD)
• Hemofiltration on-line endogenous reinfusion (HFR)

A method derived from that dialysis is used more often in intensive care is continued therapy (Continuous Artero Venous Haemofiltration or CAVH or Continuous Veno Venous Haemofiltration or CVVH)

The extracorporeal hemodialysis or extracorporeal treatment is the most widespread and is mainly carried out at clinics equipped (dialysis). Peritoneal that if properly practiced has equal efficiency. However, it is practiced at home, which is an advantage as it respects the autonomy of the patient, but requires assistance from a family member or the patient is autonomous and able to engage in treatment. The cost of the two methods is similar with a slight predominance of hemodialysis whose costs vary because of the methodology and therefore the material used

Continuous therapy is indicated as adjunctive therapy in the form of purifying the acute intoxication of severe fluid overload, in order to remove toxic substances from the blood circulating and thus facilitate the detoxification and in cases of temporary interruption of renal function following severe traumatic events involving many organs. In these cases we resort to specific methods of treatment, characterized by (relative) low efficiency and long life.

[Peritoneal dialysis]
Peritoneal dialysis is a physical therapy adopted for the treatment of ' renal failure in which the purification process takes place inside the body using the dial sate as a membrane peritoneum .

It is based on extensive visualization of the peritoneal membrane. This type of dialysis is usually done at home after a training period at the dialysis centers. In its most basic application of the technique is simple: a certain volume of solution dialysate (usually 2 liters) is entered in the ' abdomen via a catheter permanently, creating the conditions for a gradual rebalancing using the same mechanisms that govern the hemodialysis bypass. The liquid is then removed (along with the toxins that have accumulated in it) and the process begins again. This process is there as the "exchange" because the patient removes the liquid by connecting a catheter bag to bag and then connects with a liquid "clean" and fills the peritoneum. This method is called unremitting ambulatory peritoneal dialysis (Continuous Ambulatory Peritoneal Dialysis - CAPD).

A variation of the treatment is done at night, while the subject sleeps, with special machines such Cycler (peritoneal dialysis).

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