Home.News.Education.Hemodialysis 101 | 3 Minutes! A Comprehensive Guide to Hemodialysis Treatment Modes and Functions February 2024, Issue 9
Education
Hemodialysis 101 | 3 Minutes! A Comprehensive Guide to Hemodialysis Treatment Modes and Functions February 2024, Issue 9
Chronic renal failure (CRF) is the ultimate outcome of various chronic kidney diseases. When kidney function is lost, the treatment options include kidney transplantation, continuous hemodialysis, and continuous peritoneal dialysis. Due to limitations such as organ availability, surgical costs, transplant rejection, sterility requirements for peritoneal dialysis, and risk of infection, continuous blood purification remains the preferred clinical treatment.
1. Functions of Hemodialysis
Hemodialysis is a treatment process that uses specific equipment and methods to remove toxins, waste products, abnormal substances, and excess fluids from the patient's blood. Its main functions are:
1. Removing waste and toxins.
2. Maintaining electrolyte and acid-base balance.
3. Filtering out excess fluids, especially from the blood.
4. Removing inflammatory mediators to control inflammation.
2. Treatment Modes of Hemodialysis
Hemodialysis treatment is the most important renal replacement therapy for CRF patients. The treatment modes include:
· Hemodialysis (HD)
· Hemofiltration (HF)
· Hemodiafiltration (HDF)
· Hemoperfusion (HP)
These terms might sound similar as they all fall under hemodialysis treatment, but why are they distinguished into different modes?
We know that uremic toxins can be classified into several types:
· Small molecule toxins (<500 Dal) such as urea, guanidine compounds, and phenols.
· Medium molecule toxins (500-10,000 Dal) such as parathyroid hormone.
· Large molecule toxins (>10,000 Dal) such as proteins.
Currently, no single method can remove all types of toxins, which has led to the development of multiple treatment modes.
3. Differences in Treatment Modes
What are the differences in how each treatment mode removes uremic toxins and solutes?
Let's First Look at a Summary Chart:
Principles
Cleared Substances
Main Applications
HD
Diffusion: Caused by the solute concentration difference on both sides of a semipermeable membrane.
Mainly small molecules
End-stage renal disease, acute kidney injury, etc.
HF
Convection: Similar to the principle of normal glomerular solute clearance.
Mainly medium molecules
Inadequate conventional dialysis, unstable cardiovascular function, etc.
HDF
Diffusion and Convection: Combination of both actions.
Small and medium molecules
Inadequate dialysis, unstable cardiovascular function, etc.
HP
Adsorption: Removal through adsorption.
Medium molecules and protein-bound compounds
Acute drug or toxin poisoning, autoimmune diseases, uremia with severe complications, etc.
In Brief:
· HD (Hemodialysis): Has a high clearance rate for small molecules.
· HF (Hemofiltration): Has a high clearance rate for medium molecules.
· HDF (Hemodiafiltration): Combines the advantages of both HD and HF, effectively removing both small and medium molecule toxins.
· HP (Hemoperfusion): Has a certain clearance effect on medium molecules but is less effective in removing water, electrolytes, and urea. It is more commonly used in clinical settings to treat drug and toxin poisoning.
Research has shown that each treatment mode can alleviate symptoms to some extent, thereby improving patient survival rates and quality of life.
Patients must also pay attention to important matters such as scientific evaluation, treatment frequency and duration, establishment and care of vascular access, infection prevention, and correct medication use to ensure the safety and effectiveness of the treatment.
In the next issue, we will provide more educational information about hemodialysis. We welcome kidney disease patients to bookmark, follow, and share this information. If you have other suggestions or topics of interest, feel free to leave us a message.
Let's continue learning about hemodialysis in the next issue!
References:
1. Ma Xiaobo, "Blood Purification Therapy, Improving Life Quality," Family Medicine. Happy Health, 2023, (12), 72-73.
2. Zhang Mingbo, "Effect of Different Dialysis Modes on the Treatment of Chronic Renal Failure Uremia Patients," China Min-kang Medicine, 2020, 32(20), 31-33.
3. Zhang Jun et al., "Comparison of Solute Clearance Characteristics in Different Blood Purification Methods for Patients with Chronic Renal Failure," Journal of Nantong University (Medical Edition), 2018, 38(04), 305-307.
4. Quan Ye, "Clinical Efficacy Comparison of Three Blood Purification Methods for Chronic Renal Failure," World Complex Medicine, 2020, 6(07), 31-33.
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