The kidneys perform a very important function in the body, as they purify the blood, remove excess fluid, and normalize the water-alkaline balance. The cessation of the functioning of this organ leads to intoxication of the body and the death of the patient. To avoid a fatal outcome and improve the well-being of a person before a transplant operation, an artificial kidney apparatus is used.
What is hemodialysis for?
Due to various pathologies, the amount of functional renal tissue decreases sharply. This condition is called renal failure. There are certain factors contributing to its occurrence, in particular, such as:
- pyelonephritis;
- oncological diseases;
- worsening metabolic processes;
- diseases of the blood.
Renal failure provokes intoxication of the body, leads to the accumulation of metabolic products and toxins in the blood, as well as insufficiently good fluid excretion.
In this case, transplantation of this organ is indicated, however, the process of waiting for a suitable donor can take a lot of time, therefore, the "artificial kidney" apparatus is used. Hemodialysis helps to prolong the patient’s life, makes it possible to maintain a normal state before transplantation, and also allows you to lead an active life.
The main types of devices
It is possible to carry out hemodialysis not only in a hospital, but also at home, as there are small devices for home use or constant wear.
From a functional point of view, the artificial kidney apparatus is distinguished only by some technical characteristics and membrane area. In addition, the level of manufacturability is of great importance, since in modern devices the solution is prepared by the equipment itself according to available indicators.
The monitoring support system is good enough and allows you to control the level of pressure or hemoglobin changes, and then independently adjust the composition of the solution. However, this can only be done by the bulky “artificial kidney” Dialog + device, as well as Gambra, Baxter-1550 devices used in a hospital. The capabilities of portable models, especially those that are designed to be worn on the belt, are very limited.
Devices for a hospital
Modern medical devices for hemodialysis are a high-speed and high-precision computer designed for high-quality and continuous monitoring of the patient's condition and analysis of indicators. A device "artificial kidney" "Frezenius" is considered to be a good enough and functional device. Its main advantage is that developers have implemented modern software. This allows you to save doctors from constant monitoring.
The 4008S artificial kidney device can automatically calculate the rate of solution intake, control the dosage, monitor hemoglobin levels, and also measure blood pressure.
Portable home appliances
Nowadays, devices intended for home use are widely released. Manufacturers of "artificial kidney" devices are improving their products more and more every year, and the most modern of them are put on a belt and weigh only 4-7 kilograms. In this case, hemodialysis is carried out daily, and the duration of the procedure is 2-4 hours. Many doctors consider this method to be the most effective, therefore it is very common in European countries. Despite the fact that the price of the "artificial kidney" apparatus for home use is quite high (from $ 5,000), many people prefer to use this particular type of product.
The main advantages of this method include safety, as well as ease of use. However, there are some disadvantages of the device, which include a high cost, as well as the need for monitoring by a medical professional, especially at first.
Artificial kidney function
The device "artificial kidney" is used if your own organ loses its functionality by 85-90%. This device helps:
- remove urea from the blood;
- improve metabolic processes;
- withdraw excess fluid;
- control acid-base balance;
- prevent blood clots.
In addition, it helps to saturate the blood with air, which helps to improve the well-being of the patient. Thanks to modern portable technology, hemodialysis can be performed at any convenient time without leaving your home.
How is the device
The principle of operation of the "artificial kidney" apparatus is based on the fact that the device receives blood from the patient, cleans it and returns it back. The device consists of 3 main blocks that perform a different function. The blood processing unit consists of pumps for its transportation, an air removal system, as well as sensors that allow you to monitor the level of pressure in the veins and arteries. The block for creating a solution includes a system for mixing water and concentrate. Also included is a system for monitoring the level of filtration and detection of blood in solution. The dialyzer includes a membrane designed for hemodialysis.
In its structure, the device can be lamellar or capillary. Plate devices are characterized by the fact that with their help it is very convenient to control the level of blood filtration, and they also reduce the risk of thrombosis.
Capillary devices are characterized by the fact that they use a membrane through which blood flows in one direction, and the dialysate solution is returned, ready for long-term use.
A group of scientists in 2010 developed an apparatus implantable in the patient’s body, and successfully applied it in practice. Such a device is compact and does not cause inconvenience. It works due to intense blood pressure and does not require power supply.
The principle of operation of the apparatus
The principle of operation of the "artificial kidney" apparatus is based on the fact that it is connected to the human circulatory system, blood from the venous system begins to move to the membrane. On the other hand, a dialysis solution enters for cleansing. As a result, the blood gets rid of toxins. The purified blood then flows back into the venous system.
The dialysate is prepared in advance, taking into account the characteristics of the patient and his physical condition. The device system independently creates a solution using distilled water and a concentrated product according to available parameters. After the procedure, its effectiveness is evaluated according to several parameters.
Hemodialysis using an artificial kidney
Blood purification is mainly carried out 2-4 times a week. With the course of the acute form of the disease, its daily implementation is shown. The process itself is controlled by a nephrologist or resuscitator and can take from 2 to 7 hours.
Hemodialysis is performed in a hospital or on an outpatient basis in a clinic. Before the procedure, you need to weigh the patient to determine the amount of excess fluid that needs to be removed from the body, as well as measure the pulse and pressure. Then the patient sits in a chair, the doctor inserts a catheter into a vein and connects it to the device. Blood is absorbed into the dialyzer chamber, then passes through the filtration system and returns in purified form back to the body. The composition of the solution and its concentration are determined individually for each patient.
During hemodialysis, the patient must be in a calm state and lie still. After that, the level of urea is measured.
Reviews of patients and doctors about the hemodialysis procedure are mixed. Many believe that this is the only salvation when there is no possibility of organ transplantation. Doctors say that thanks to the advent of modern devices, the procedure has become safer, and if performed correctly, patients can live for 20-30 years. However, maintaining a healthy lifestyle and following a diet is also important.
Some patients report the occurrence of side effects after the procedure, as well as worsening. Doctors note that the body of each person is individual, so you should not expect the same effect of the device on different people.
Indications for the procedure
The "artificial kidney" apparatus is used in pathological conditions when there is no other way to cleanse the blood of accumulated poisons and toxins. The main indications for the procedure include:
- acute renal failure;
- chronic failure;
- pyelonephritis;
- overhydration;
- poisoning with toxic substances;
- ethyl alcohol poisoning.
All these diseases are not an absolute indication for blood purification, therefore, before the appointment of the procedure, it is necessary to take blood and urine tests to determine the level of harmful substances. It can also be prescribed for diabetes mellitus, since the sugar level is normalized, which helps to prolong the patient's life.
Contraindications to the procedure
Hemodialysis also has certain contraindications, which must be taken into account. Contraindications include conditions such as:
- blood diseases;
- heart disease
- damage to the central system and various mental disorders;
- infectious diseases;
- severe form of hypertension;
- tuberculosis of internal organs;
- oncological diseases.
In addition, one of the contraindications is the patient's age of more than 80 years.
Dieting
The results of hemodialysis are largely dependent on nutrition. In this case, non-compliance with the diet can lead to a deterioration. It is prescribed individually, since it is very important to take into account the recommendations of a nephrologist, cardiologist and endocrinologist. The main principles of the diet are:
- restriction in consumption of table salt;
- elimination of foods rich in potassium from the diet;
- exclusion of foods that promote fluid retention;
- control the amount of calcium in the body;
- decrease in consumption of sweets.
It is also advisable to limit fluid intake and monitor your weight, as a set of several kilograms indicates an unbalanced diet. It is advisable to cook or steam products. Nutrition should be fractional and balanced.
Possible complications and side effects
The procedure for conducting blood purification is not as safe as we would like. An artificial kidney in some cases leads to side effects such as:
- itching of the skin at the injection site of the catheter;
- erythrocyte reduction;
- pressure surges;
- pain and muscle cramps;
- sleep disturbances;
- decrease in bone strength.
There is also the possibility of more serious complications, in particular such as inflammation of pericarditis. Equipment may malfunction, resulting in patient death.