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Synthesis and Engineering of Polymeric Latex Particles for Hemodialysis Part I—A Review
Published in Wolfgang Sigmund, Hassan El-Shall, Dinesh O. Shah, Brij M. Moudgil, Particulate Systems in Nano- and Biotechnologies, 2008
S. Kim, H. El-Shall, R. Partch, B. Koopman
Hemodialysis is a widely used life-sustaining treatment for patients with ESRD. However, it does not replace all of the complex functions of a normal healthy kidney. As a result, patients on dialysis still suffer from a range of problems, including infection, accelerated cardiovascular disease, high blood pressure, chronic malnutrition, anemia, chronic joint and back pain, and a considerably shortened life span. One significant limitation of the current dialysis technology is the inability to efficiently remove larger toxic molecules. This is mainly because of the broad pore size distribution reducing the selective removal of toxins, and unsatisfied biocompatibility, causing complications such as inflammation, blood clotting, calcification, infection, etc.
Hemodialysis Membranes for Treatment of Chronic Kidney Disease: State-of-the-Art and Future Prospects
Published in Sundergopal Sridhar, Membrane Technology, 2018
N.L. Gayatri, N. Shiva Prasad, Sundergopal Sridhar
Patients suffering from end-stage renal disease (ESRD) undergo dialysis, where an artificial setup is used to filter uremic wastes, salts and excess fluids from the body, restoring it to its normal healthy balance. Dialysis can be done in two ways: one is hemodialysis (HD) and other peritoneal dialysis (PD). Removal of uremic toxins carried out using a hollow fiber membrane module is called hemodialysis. In PD, dialysate fluid is filled in the abdomen where the peritoneum (a thin walled cavity made of tissues) acts as a filtrating media and permeates uremic toxins and excess fluids into the dialysate solution, thus purifying the blood within the body.
Biological-Derived Biomaterials for Stem Cell Culture and Differentiation
Published in Gilson Khang, Handbook of Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine, 2017
Although dialysis is currently an available treatment for chronic renal disease, it replaces only the filtration function of the kidneys and thus, it is associated with a number of complications and is not a permanent solution. Kidney transplantation performed in a heterotopic location is the only definitive solution for end-stage renal failure. A potential solution to ease the demand for donor kidneys may be the use of tissue engineering techniques that could be used to develop functional kidneys. Ross et al. developed a whole-organ decellularization protocol using whole rat kidneys and detergent perfusion through the renal artery.116 The detergent-based perfusion protocols successfully produced acellular kidneys that were nearly transparent yet retained the web-like appearance of the basement membrane architecture. SEM showed a continuous 3D ECM of acellular glomerular, tubular and vascular structures. In addition, immunohistochemical staining showed a completely contiguous network of laminin and collagen IV, which are primary constituents of the kidney basement membrane, and both are involved in cellular viability, migration, and differentiation. Baptista et al. used the native vascular system to perfuse a decellularization solution (Triton X-100 and ammonium hydroxide in DI water) through the kidney by cannulating the largest vessels for vascular access.117 This method produced completely decellularized tissues that demonstrated a preserved vascular network. The integrity of the vascular network was confirmed by fluorescent imaging after fluorescent dye perfusion. This showed that fluid injected into the vasculature could flow through the vasculature and not extravasate throughout the organ.
Potential clinical value of catheters impregnated with antimicrobials for the prevention of infections associated with peritoneal dialysis
Published in Expert Review of Medical Devices, 2023
Hari Dukka, Maarten W. Taal, Roger Bayston
Patients who develop end-stage kidney disease (ESKD) need renal replacement therapy (RRT) to survive. RRT includes dialysis treatment and transplantation. Dialysis can be done in-center, which involves visits to hospital or a dialysis center, or at home. Peritoneal dialysis (PD) is a form of home dialysis, which has been in use since the 1950s. To enable PD, a catheter is inserted into the abdomen (pouch of Douglas), and dialysis fluid (containing electrolytes and glucose or an alternative osmotic substance) is infused into the peritoneal cavity. The peritoneum acts as a semi-permeable membrane and allows removal of toxic substances and excess water. There are several advantages of dialyzing at home, which include better quality of life compared to in-center hemodialysis (HD) [1]. PD also has an advantage of causing no hemodynamic compromise and better preservation of residual kidney function, which has been shown to improve patient survival [2]. PD is also relatively cost-effective due to lower staff costs and does not require large amounts of building space for delivery. Consequently, the PD patient population prevalence has been increasing considerably around the world [3]. Due to the COVID pandemic, there has been significant strain on health-care resources and in-center hemodialysis facilities, highlighting the benefits of home-based PD. There are currently estimated to be 369,000 ESKD patients receiving peritoneal dialysis worldwide, representing 11% of the global dialysis population [4].
Innovative use of operational tools to improve care delivery for the uninsured ESRD patients and to inform healthcare policy-makers
Published in IISE Transactions on Healthcare Systems Engineering, 2022
Farnaz Nourbakhsh, Olga Bountali, Sila Çetinkaya
To this end, Patient Set Up and Nephrologist Evaluation durations are fairly fixed–15 minutes each on the average. Dialysis Treatment, on the other hand, requires from 3.5 to 4.5 hours, depending on the amount of excess fluid. Regarding DR resources, there are 13 dialysis machines and 1 physician available constantly. However, DR differs from ER in the following two aspects: First, DR does not operate on a 24/7 basis, but from 6am to 10 pm. We refer to this unique characteristic as the DR “on-off” operation. Clearly, if a patient reaches DR during its “off” period, additional delays are caused. Second, unlike all the other steps, Patient Set Up does not maintain a fixed number of resources throughout a day. Instead, the day is divided in three periods and the number of nurses changes from one period to the next, with 9 nurses available from 6am to 10am, 11 nurses from 10am to 6 pm, and 2 nurses from 6 pm to 10 pm. This is due to the fact that nurses work on a 12 hour shift, either from 6am to 6 pm or from 10 am to 10 pm. Hence, the overlapping of these two shifts results in the three periods mentioned above. Subsequently, capacity to accommodate more patients is greater in the beginning and middle of a day relative to the end of the day. The above characteristics also constitute very critical modeling input for our purposes.
Diffusion analysis with high and low concentration regions by the finite difference method, the adaptive network-based fuzzy inference system, and the bilayered neural network method
Published in Engineering Applications of Computational Fluid Mechanics, 2021
Qike Shao, Sina Faizollahzadeh Ardabili, Majdi Mafarja, Hamza Turabieh, Qian Zhang, Shahab S. Band, Kwok-Wing Chau, Amir Mosavi
Microorganisms, plants, as well as animals are some examples that the role of diffusion of large and small molecules in aqueous solutions is inevitable. Aside from these, the process of diffusion has its own role in food processing as well as the drying of liquid mixtures and solutions. Examples include aroma as well as flavor components in tea and coffee during the process of evaporation. Moreover, diffusion occurs in the process of fermentation. In this process, sugar, oxygen as well as nutrients diffuse to products, microorganisms, and waste. In this regard, kidneys are responsible for taking away different products, including creatinine, urea, and other excess fluid from the blood. Additionally, kidney dialysis helps patients whose kidneys work improperly by removing waste products from their blood. During the process of hemodialysis, a dialyzer is applied, and in this process, blood is pumped; consequently, waste that exists in blood diffuses by a sort of membrane action so that only particular molecules can pass to the aqueous solution cleaning fluid.