Learning The Basics About Dialysis Membranes

As Joe Cosgrove has already said in this blog, dialysis is a method used on patients who have End Stage Renal Disease (ESRD) and whose kidneys are not able to filter blood properly in order to remove waste from it.

Renal Dialysis Technician

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As the dialysis process needs to filter blood waste, it should use a membrane in order to do so. Nowadays, most of these membranes are artificial ones, made out of polymer compound and blends. The most common polymer used to manufacture dialysis membranes is regenerated cellulose. However, many companies have developed modified cellulose membranes and even synthetic polymer membranes that are useful to filter blood.

Dialysis membranes are used clinically to remove waste from the patient’s’ blood. Most of this waste is made of uremic toxins that would otherwise cause blood intoxication. Besides removing waste, these membranes are responsible for providing the lacking dialysate ions the body needs to properly function.

As the number of patients who need dialysis increases so does a number of dialysis membranes that are required to treat them. Every year, at least 70 million square meters of dialysis membranes are used in the world. The most common type of dialysis membranes that is used to remove accumulated toxins is made of hollow fibers. A hollow fiber membrane included numerous materials, such as cellulose and other synthetic polymers.

Related: Which dialyser membrane to choose?

A Bit Of History

At first, dialysis membranes were made of cotton or cotton derived fibers. These membranes were thought to be natural ones and their structure would activate blood leukocytes and their immunity response. Due to this, the body started to develop inflammatory responses and finally, it was concluded that those membranes were not biocompatible with the body.

In time, scientists started to develop polymers made of both natural and synthetic compounds in order to mitigate the body’s response and further development of inflammatory reactions. This is how it was concluded that cellulose was more biocompatible to the body and didn’t cause as many reactions as cotton would do. Research institutions started to develop cellulosic membranes that were highly more compatible to the body and modified cellulosic membranes were born.

Many membranes have been developed over the years. Currently, we can find synthetic membranes with higher filtration capacity due to the larger size of their pores. This way, synthetic membranes can remove more particles than “natural” ones would do. This is how, besides the low flux cellulose membranes, five types of high-flux synthetic membranes can be found in the market today.

Characteristics

Biocompatibility: This characteristic describes how a membrane can cause a biological or biochemical effect on the body. In other words, is there is an inflammatory reaction in the body, the membrane is not biocompatible because it activated the leukocytes and made them react. This usually happens when natural fibers are not modified.

The main cause of death in dialysis patients is caused by these inflammatory responses. When healthcare providers use synthetic materials, patients have a better response to the dialysis treatment. This happens because high-flux synthetic polymers don’t activate leukocytes as unmodified cellulose membranes do, therefore they are considered to be more biocompatible to the body and their mortality rate associated with them is lower.

Impermeability: This characteristic is related to the membrane’s impermeability to dialysate impurities such as bacteria. Dialysate can be easily contaminated by other substances, allowing dangerous substances enter the body through the membrane directly to the blood stream.

Those membranes with larger pores, paradoxically, have fewer chances of filtering bacteria directly to the blood stream. This happens because membranes with larger pores are more absorbent that those with smaller pores. This way, synthetic membranes or cellulose modified membranes can absorb more bacterial products of dangerous substances for the body. These membranes are considered to be more impermeable to impurities.

However, it is recommended to use pure dialysate on patients, simply to avoid taking any potential risk that may affect the patient’s health. Using a synthetic membrane can be understood as taking an additional precaution.

Adsorption: As it was said before, membranes used during the dialysis process need to be absorbent. This way, they can remove any potential threat present in the dialysate fluid. There are some peptides, necrosis factors, and other substances that should be absorbed by the membrane in order to keep the body healthy.

In order to increase the membrane’s capacity to absorb impurities, most dialysis machines also include other inner systems such as beads with special properties meant to absorb harmful substances. This way, the absorption capacities won’t rely exclusively on the membrane, but also on the dialysis machine.

Filtered

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Pore size: This characteristic varies from one material to another. Natural membranes have smaller pores and synthetic membranes have larger pores. Nowadays, scientists and researchers have created new synthetic materials and compounds that allow membranes to have larger pores, increase the flux and properly remove harmful substances.

How To Make The Transition To Your Life On Dialysis

Undergoing dialysis treatment is something that will definitely change your life. As we have mentioned here on numerous occasions at Joe Cosgrove’s blog, living with dialysis has a lot to do with adjusting to the new definition of what you consider normal in your daily routine and the way you look at life in general. With that being said, it doesn’t mean that everything you enjoy doing has to stop because of your treatment and that you simply have to adjust to a life that excludes you from things like traveling, eating anything you want and working like everyone else. Dialysis simply becomes part of who you are and the way you go about those activities that bring you joy is just a bit different, even more fulfilling at times.

FAMILY

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One of the biggest challenges of living with dialysis is probably one of the things that has to do the least with the treatment itself, and that is accepting it. Dialysis is a big word that conjures up images of sickness, needles, hospitals and pain; most of that has to do with a bad reputation that it has acquired over the years and just the ignorance sported by the general population when it comes to kidney disease. These types of treatment exist to make you better and every single day there are brilliant minds and large amounts of resources working hard at advancing this processes even more with the aid of cutting-edge technology in an attempt to give patients a better quality of life and a warmer acceptance of what living with dialysis means.

Today on our blog, we want to talk a little about the beginning of your life with dialysis and what you should expect in the first couple of months while you get used to it so you can make the best out of this challenging time in your life.

Understand the alternative

Dialysis is a relatively new treatment and before that, there was nothing that you could do for patients with kidney failure, something that pretty much meant that you were looking forward to an extreme decline of your health and most likely dying from your condition. Today dialysis can not only keep you alive, but it can do with while giving you a considerable quality of life as it becomes such a manageable part of you, that you will simply come to live with it seamlessly.

The dialyzer has limits

The machine that is helping you clean your blood during the dialysis treatment is not a magical device that can completely replace your kidneys. Kidneys are truly remarkable organs and are able to withstand a lot of damage before failing, they are truly irreparable and no machine exists that can do what they do as well as they do it. Understanding that is crucial for you to realize that while internally there isn’t much else you can do to help your kidneys other than undergoing the treatment, externally there is a lot you can do to compensate for the dialyzer shortcomings. Things like eating healthy, exercising and taking care of yourself so as to alleviate the stress your body has to go through are great ways to making sure that all your efforts are directed towards making the treatment work as well as it possibly can.

Find ways to make yourself comfortable

Yes, you are just lying down and reading or watching TV waiting for the treatment to be over, but as you are apparently relaxed and not doing much, your body is working overtime dealing with everything that is going on. Your blood is being extracted, cleaned and then pumped back into your body constantly during a session that may last up to four hours, this means that your body has to take all these in and push itself to compensate. It is very common to feel tired even if you think you did nothing during the day. Give your body time to get used to the changes.

Lean on your support network

Give the people in your life who care about you the opportunity to be there with you and to participate in whichever way you think it will make the process easier for you. Those around are also affected in their own way, so make sure you don’t neglect this support network and allow it to help you get through the tough times. People in the dialysis community are also very supportive of new members and will answer your questions and take you in if you need anything. You should take advantage of their experience and knowledge dealing with dialysis and even share with them the ways that you are making it work for yourself. Remember you are not alone in this and the condition can be a bonding experience with your family, friends and other loved ones.

What is it like to live with dialysis?

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In the United States at least 217,000 patients need to live with dialysis. This represents national costs for over $11 billion dollars every year. This procedure needs to take place when the kidneys are unable to filter fluids and their full capacity is lost. Sometimes, patients who need to live with dialysis have to do so because they were born with a kidney condition and they cannot afford a kidney transplant.

Statistically speaking, this is a dramatic situation for thousands of people in the United States. However, most patients seem to believe that dialysis is not such a terrible thing and they have adapted to a “new normal life”. But, what does it means to live with dialysis? In this article, Joe Cosgrove will share some details related to the way patients learn to have regular lives while they depend on dialysis to survive.

The Experience

First of all, when a patient decides that it is time to go under dialysis treatment it is because its kidneys are not able to do their job. This means that dialysis becomes the only alternative to survive. Keeping this in mind makes it easier and more motivating to people who need to go under treatment.

During a regular dialysis routine, the patient needs to come to the dialysis clinic and meet the nurse at the counter. Papers and forms will be filled out and a short checkup will take place. Since most patients have done this a thousand times, the process usually doesn’t take long.

After the checkup, the patient settles into one of the comfortable recliners inside the room where the process usually takes place. The patient may be the only one in the room or not, depending on the day and time it decides to go and get the treatment.

After settling, the patient will need to prop its left arm, allowing the technician to slip a couple needles into its blood vessels (close to the wrist). One of the needles is in charge of removing the blood and the other one is in charge of taking it back to the body. These needles are attached to plastic tubes that at the same time are connected to the dialysis machine.

For the next three hours, the needles will do their job and the patient’s blood will be filtered. All this is possible thanks to the dialysis machine that stands still next to the patient’s recliner. Most patients bring a book or spend this time watching a movie or a TV show on Netflix. Sometimes, this is even the perfect moment to take a nap.

Besides from the initial moment of the procedure, when the needles need to be stuck on your veins, the dialysis process doesn’t hurt. Sometimes patients may feel dazed and their blood pressure can drop. But, other than that, the process takes place in a comfortable way.

blood-pressure-pressure-gauge-medical-the-test

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Living with dialysis is supposed to make things easier for patients with End Stage Renal Disease (ESRD). However, the mortality rates in the United States remain to be considerably high compared to those in Japan or Europe since many patients choose to skip the procedure or don’t accept it to last for too many hours.

Related: How To Make The Most Out Of Your Time On Dialysis

How Dialysis Works

The best way to describe the dialysis process is as an artificial kidney. This means that dialysis should be able to do what your kidneys cannot do anymore. There are two different forms of dialysis: hemodialysis and peritoneal dialysis. At least 90% of the patients in the United States who live with dialysis choose to go under the hemodialysis treatment. This is the procedure that was described in the experience above.

When patients live with hemodialysis, their blood needs to be circulated outside of the body with the help of a hemodialysis device. This device cleanses the blood and then returns it back to the body of the patient.

Not everyone is a right candidate to get hemodialysis. This is why every patient needs to have the doctor’s approval before having an entrance or access (a minor surgery on the leg, arm or neck to access the blood vessels). This access is called fistula and the patient will need to keep it clean and usable for as long as it needs to go under dialysis treatment.

The fistula is something dialysis patients need to learn how to live with since it is the only way doctors have to access the blood in a fast and effective way. Fistulas are joints between arteries and veins located under the skin that form a larger vessel where needles are inserted.

When patients don’t need to live with dialysis and only go under a temporary treatment, they can get a catheter on their neck and there is no need for them to go under this minor surgery. In the case of the fistula, the wound needs to heal before the dialysis treatment takes place. However, in case patients use a catheter, they can go under the dialysis treatment right away and the procedure is slightly different.