Machines for Hemodialysis

Water quality and adverse health effects on the hemodialysis patients: An overview

Hemodialysis is considered a treatment of choice for patients with renal failure worldwide, allowing the replacement of some kidney functions by diffusion and ultrafiltration processes. Over 4 million people require some form of renal replacement therapy, with hemodialysis being the most common. During the procedure, contaminants in the water and the resulting dialysate may pass into the patient's blood and lead to toxicity. Thus, the quality of the associated dialysis solutions is a critical issue. Accordingly, the discussion of the importance of a dialysis water delivery system controlled by current standards and recommendations, with efficient monitoring methods, disinfection systems, and chemical and microbiological analysis, is crucial for improving the health outcomes of these patients. The importance of treatment, monitoring, and regulation is emphasized by presenting several case studies concerning the contamination of hemodialysis water and the adverse effects on the respective patients.

Effectiveness of Comprehensive Nursing in Hemodialysis of Patients with Chronic Renal Failure and the Impact on Their Quality of Life

Objective

To assess the effectiveness of comprehensive nursing in patients with chronic renal failure undergoing hemodialysis and the impact on their quality of life.

Methods

The present study included 86 patients undergoing hemodialysis for chronic renal failure from January 2020 to October 2021 and randomly assigned them to receive either normal nursing or comprehensive nursing, with 43 cases in each group. Outcome measures included psychological status, treatment compliance, quality of life, and complications of the eligible patients.

Results

After the intervention, comprehensive nursing resulted in lower Self-Rating Anxiety Scale (SAS) scores and Self-Rating Depression Scale (SDS) scores and higher quality of life scores for patients versus routine nursing (P < 0.05). Comprehensive nursing was associated with a significantly higher overall patient compliance rate versus routine nursing (P < 0.05). Patients receiving comprehensive nursing had a lower risk of developing complications versus those given routine nursing (P < 0.05).

Conclusion

Comprehensive care increases treatment compliance and self-care capacity of patients undergoing hemodialysis for chronic renal failure, improves their quality of life, and lowers the risk of complications, indicating a high potential for clinical advancement.

Device and Technique for Extracorporeal Blood Volume Sequestration During Hemodialysis

We developed a technique for a controlled and reversible volume perturbation of the cardiovascular system during hemodialysis. The capacitance of the extracorporeal circulation was modified by an expansion bag, using separate filling and draining lines connected to postpump and prepump sections of the arterial line segment, respectively. The connection to this bag was manually operated by three-way valves. The volume sequestered into the blood bag was continuously measured by a weighing scale. Filling and draining of the expansion bag was measured in eight patients in two subsequent routine dialysis treatments. Four volume shifts were done in each treatment. Filling and draining rates and times depended on extracorporeal blood flow as well as arterial and venous line pressures. Bag inflow and outflow volumes were 215.8 +/- 28.5 ml/min and 221.6 +/- 37.0 ml/min, respectively. The total volume transiently sequestered in the bag was 479.8 +/- 61.3 ml. The duration of the whole test was 4.5 +/- 0.8 minutes. During filling, residual dialyzer blood flow was transiently reduced to 58.5 +/- 21.6 ml/min and the filtration fraction reached 30 +/- 13%. There were no adverse events such as clotting in the blood bag or in the dialyzer. The method provides rapid, reversible, and safe volume shifts between the patient and the extracorporeal circulation with the potential to elicit a hemodynamic response for characterizing the patient during each dialysis treatment.