Discuss:Dialysis/Archive 1 – Wikipedia

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Haemodialysis – Ultrafltration

There is a main error within the haemodialysis explaination, the textual content implies that water is eliminated by passage down an osmotic gradient, that is unfaithful for all besides the earliest (submit Nineteen Fifties) haemodialysers.

Small molecules (Urea, and many others) move down a focus gradient for that molecule into the dialysate. Water, nonetheless, passes down a stress gradient type blood facet to dialysate facet (decrease stress) the speed of water loss is decided by alterng this trans-membrane stress gradient. Sodium Chloride then equilbrates with the water misplaced. This course of is termed ultrafiltration. In contrast to Peritoneal Dialysis there isn’t any osmotic gradient in standard Haemodialysis.

  • fixedHswapnil 16:00, 3 October 2005 (UTC)

Grafts?

Ought to one thing about grafts be talked about below the varieties of entry in hemodialysis? Together with fistulas and catheters, grafts are a quite common methodology of entry for hemodialysis (that is about all I do know, nonetheless). — Natalya 04:48, 21 November 2005 (UTC)

Steps of dialysis

the entire part about what occurs when a affected person comes for dialysis sounds misplaced…ought to we make it a separate subheading? (somewhat than scrapping it altogether, i suppose a affected person going for the primary time might discover it helpful)Hswapnil 19:03, 28 October 2005 (UTC)

Please edit this in response to your expertise. I’ve discovered it a bit dense to edit. JFW | [email protected] 01:14, 30 October 2005 (UTC)
I made a begin on it (sub-divided it) after splitting-out the hemodialysis part. I feel it’s helpful… simply wants a superb re-work. Nephron 17:27, 17 December 2005 (UTC)

Clear-up

Does anybody thoughts if I do a serious clean-up on this text once I’ve completed on the PD and HD break up pages? When that is achieved, it should make a lot of this web page redundant, and the structure is appalling anyway. I feel the concentrate on this web page ought to actually be about renal alternative remedy and the rules of dialysis-most of the remainder of it may simply be chucked.
Whaddya suppose?Felix-felix 16:50, 30 January 2006 (UTC)

Go for it –KBrown 19:34, 31 January 2006 (UTC)

I might flip this right into a disambiguation web page with hyperlinks to hemodialysis, peritoneal dialysis, steady veno-venous hemofiltration, “liver dialysis” and different doable meanings. JFW | [email protected] 17:15, 1 February 2006 (UTC)

No Baxter? Over 50 lifeless are crying from the grave over one other signal of US censorsip at wikipedia.

How come there is not a single phrase in regards to the “Baxter Althane” scandal on your complete Wikipedia, the failed CIA operation which in all probability tried to get rid of recognized kidney affected person Osama bin Laden with poisoned dialysis tools, however ended up killing about 50 individuals in Europe as a result of two shipments being blended up on the port?

What on earth are you speaking about? Who censored what? Anyway, it sounds very fascinating however can’t be included until you will have impartial, beforehand printed and verifiable materials. In the event you may present that, I see no fast motive why the Baxter Althane challenge can’t be lined. JFW | [email protected] 15:18, 4 November 2005 (UTC)
Baxter Althane catastrophe… really there’s something on Wikipedia, anonymous buddy. Karmafist 04:30, 19 February 2006 (UTC)

Proposed merge

I feel there was adequate settlement right here for the split– if you happen to learn the varied feedback right here. I don’t see any compelling motive to re-open that dialogue. Additionally, I don’t suppose a merge can be a superb thing– because it isn’t solely hemodialysis that obtained split-out… there may be additionally peritoneal dialysis. In the event you disagree be at liberty to voice your opinion right here… or re-post the merge field with a hyperlink to this web page (versus the hemodialysis speak web page). Nephron 04:35, 24 March 2006 (UTC)

Agreed, there’s lots on the HD and PD pages, this web page wants stripping down, not remerging the daughter pages.Felix-felix 15:21, 26 March 2006 (UTC)

Slash and Burn

Lastly achieved it, ditched many of the outdated article and added some fundamental explanatory stuff.
I do not actually suppose that there ought to be rather more on this web page besides, maybe hyperlinks to different RRTs and extracorporeal therapies…I drank alot of espresso this morning, so let me know if I’ve gone excessive. CheersFelix-felix 11:41, 30 March 2006 (UTC)

Good things. I feel the one thing– is that it may have “major article” hyperlinks, in order that it’s clear there are articles devoted to every HD and PD. Nephron  T|C 04:22, 31 March 2006 (UTC)

Good planFelix-felix 12:28, 31 March 2006 (UTC)

Kolff

We must always actually point out Willem Johan Kolff someplace. JFW | [email protected] 10:20, 17 July 2006 (UTC)

Not right here.Hemodialysis, or ideally a historical past of dialysis article-it’s a reasonably large subject, Stewart Cameron has written a guide about it I feel.Felix-felix 13:31, 18 August 2006 (UTC)

Extra hack and slash

Heavy trimming on the exterior hyperlinks, most of which have been pretty good, however weren’t instantly associated to dialysis (renal weight loss program recipes for instance) most of those, if actually wanted ought to go on the power renal failure web page. Additionally fastened some hyperlinks within the indications part.
I feel this text is fairly good now…Or am I being a self deluded idiot?Felix-felix 13:27, 18 August 2006 (UTC)

I feel the article has improved significantly. That stated, I feel just a few of the references obtained misplaced and I feel among the dialogue in regards to the initiation of dialysis was higher on this earlier model of the article. Being a robust proponent of references, I feel just a few issues have to be referenced. Nephron  T|C 03:24, 20 November 2006 (UTC)

No disagreement from me-all these articles want hundreds extra refs, and ‘m horrible at placing them in!Felix-felix 08:06, 20 November 2006 (UTC)

Different use of “dialize”

One other use of the time period “dialize” and associated phrases happens within the formulation of buffers notably buffers for stabilizing protein options. I’m not acquainted sufficient with the method, however I feel it ought to be famous and expanded upon if doable. —The previous unsigned remark was added by Williamheyn (speak • contribs) 20:27, 21 December 2006 (UTC).

Revert to “22:50, 30 December 2006 GermanX”

I reverted to the model “22:50, 30 December 2006 GermanX”. This text shouldn’t be meant to be an outline of hemodialysis or peritoneal dialysis– as these have already got separate articles. The dialogue to separate the dialysis article was made some time in the past and dialogue of it’s discovered above. I’ll add just a few feedback to the article to make this clear that the sub-articles are the place to write down extra about hemodialysis, peritoneal dialysis et cetera. Nephron  T|C 01:35, 8 January 2007 (UTC)

Photos

Simply so as to add to what Nephron sais above, this web page was meant to be a disambi type web page main on to the principle article pages, and I do know we must always attempt to get footage into WP articles, however these are all from the respective major articles and, to my thoughts, muddle up the web page, which I reckon ought to be as clear as doable.I vote chucking them out, any ideas?Felix-felix 15:12, 8 January 2007 (UTC)

I feel the photographs can go. Additionally, I feel the web page may very well be trimmed– i.e. extra of the information is moved to the subarticles. Nephron  T|C 00:59, 13 January 2007 (UTC)

Dialysis Catheters

It could be good to have a bit on dialysis catheters.
59.92.68.53 07:30, 21 Might 2007 (UTC)

Please analysis it and write it! Massively appreciated. JFW | [email protected] 22:02, 16 Oct 2004 (UTC)

I’m presently below going this however there may be a considerable amount of textual content to go thro please naked with me and i’ll have a draft achieved and dusted in some unspecified time in the future (I’m not a Renal Doctor, and due to this fact unqualified, i’m a trainee renal physician and a renal affected person for 25 years hopefully it will provide you with a various take a look at issues.)

( that is only a tough draft of what occurs )

There are an enormous quantity of various methods practiced with dialysis catheters and completely different trement throughout the globe i’ve been witness to twenty or so persuaders all with within the UK so far as am conscious most are carried out in the identical means. Please edit if they’re incorrect.

Often the affected person is checked over previous to the operation commonplace exams blood work blood stress temaputure, as soon as the outcomes are within the operation can start most of theses operation are carried out with the affected person below native anstic with some gentle ache killers there are different dimension’s and makes of dialysis catheters they are often positioned in ether facet of the neck Chest, or groin and in excessive instances within the again adjoining to the kidneys. the facet that it gos in is dependent upon the physician being proper or left handed or if theres a medical downside with the affected person.

A small incision is made above the principle artery then the catheter is entered with within the artery within the course of the blood circulation about 5 to six inches is place within the artery, below managed operations little or no blood is misplaced, and the affected person mustn’t really feel any of this as soon as within the physician then closes the pores and skin across the backside of the catheter as soon as in then it’s then connected to the sufferers physique normally with 2 or 4 stitches as soon as the physician is joyful that it’s in place and is permitting blood to circulation freely the affected person is then launched again to the actual ward for obviation for half an hour if no sine’s of ache or discomfort or obvious the affected person is normally free to go. Good to be good 09:46, 8 Apr 2005 (UTC)

Bloat

This text, which was concieved primarily as a disambiguation type web page, maybe together with just a few different generalities (indications for dialysis, for instance) is bloating quickly. Hemodiafiltration doesn’t want a bit of it is personal right here (or IMO an article of it is personal, until somebody desires to make an honest article, a tough process for my part.)-especially when the part, and the present article are taken straight from the hemofiltration article. The images culled from theoriginal articles are bloat too. I’ve already deleted the ‘Which is Greatest’ part which was content material free and did not even outline it is phrases. Until there are severe objections, I will get out my pruning shears and trim mercilessly.Felix-felix 10:09, 18 January 2007 (UTC)

  • Oops…I could have stepped on toes, as a result of I simply added some footage with out noticing these discussions. I feel that that is greater than a disambiguation web page, however somewhat an introduction to dialysis web page. Therefore, footage are applicable in my thoughts. Once more, I did not discover the talk on this web page (now 5 months outdated) earlier than making my adjustments.Gaff ταλκ 06:26, 4 June 2007 (UTC)

I imagine Dialysis ought to be derived etymologically from “dia” and “lysis”, not “dia” and “lusis”. “Lysis” means breaking down.
Regards,
Anil Raj

Convection vs. Osmosis

Osmosis is the diffusion of water however in dialysis water strikes from one facet of the membrane to the opposite through convective drive. From the linked reference the Kidney Atlas “Hydrostatic ultrafiltration additionally takes place throughout hemodialysis.
As a result of the spent dialysate effluent pump (see Fig. 1-4) creates damaging
stress on the dialysate compartment of the membrane unit
and the blood pump creates optimistic stress within the blood compartment,
there’s a web hydrostatic stress gradient between the compartments.
This causes a circulation of water and dissolved substances
from blood to the dialysate compartment. The method of solute
switch related to this circulation of water is known as “convective
transport.” In hemodialysis, the quantity of low–molecular weight
solute (eg, urea) eliminated by convection is negligible. Within the steady
renal alternative therapies, it is a main mechanism for
solute transport.”BillpSea (speak) 22:22, 3 August 2008 (UTC)

AWAK merger

I feel Automated wearable synthetic kidney would make for a superb “future applied sciences” part. Nevertheless, we must always take care embody each sections on hemofiltration and peritoneal dialysis. There are just a few papers on the market about such makes an attempt. I’ll attempt to listing/observe some down. Chaldor (speak) 06:03, 23 September 2008 (UTC)

  • Moreover, I do not suppose the web page can stand by itself due to WP:NOTABILITY and WP:NEO points. Thus it should both be merged below a extra basic context, or deleted. Chaldor (speak) 21:41, 23 September 2008 (UTC)
  • Oppose
  • I did not fairly see this text as a disambiguation web page initially, however that does make sense. This is my concern: the three articles talked about are coping with the identical basic thought, every with various ranges of spcificity. Synthetic kidney is probably the most broad of those three. Would it not make sense to maneuver the content material of the opposite two articles into the Synthetic kidney article? You stated the three aren’t the identical factor, however they’re all the identical class of gadget. The opposite two are simply subtypes of synthetic kidney. I feel they might match neatly right into a subcategory inside that article. That is simply an organizational challenge. In the event you take a look at the way in which issues are actually, WK and AWAK have their very own articles and each have been created from a business-centric place to advocate a place. For my part, each of those fail the WP:NOTABILITY standards for articles (not content material) and likewise violate the WP:NEO pointers. Chaldor (speak) 01:22, 5 October 2008 (UTC)
I feel there’s a distinction to be made between a mechanical/chemical gadget and a bio-engineered (or tissue engineered) gadget.
The Synthetic kidney article clearly states it offers with bioengineered kidneys/bioartificial kidneys which might be grown from renal cell strains/renal tissue.
I feel tissue engineered vs. non-tissue engineered is an effective division (although I am going to concede that bioreactors may straddle the division). The articles implicitly have this (tissue engineered vs. non-tissue engineered) division. The explanations these two units of gadgets don’t exist are fairly completely different. To my data, the wanting the lengthy of it’s that:

  • The previous (non-tissue engineered — which rely on the idea of dialysis (biochemistry)) would not exist because the dialysate volumes required for satisfactory dialysis are too massive to hold round.
  • The later (tissue engineered) would not exist as we simply do not know sufficient about tissue engineering– one of the best, AFAIK, anybody has achieved is tissue engineer pores and skin.
Nephron  T|C 19:08, 5 October 2008 (UTC)
  • I perceive the excellence you make. They’re positively separate concepts/strategies/implementations, however is not the definition you make for synthetic kidney merely arbitrary, and if used within the didactic as you’re proposing, constitutes a neologism? I believed the time period itself was simply describing a basic thought, and never a selected implementation. I did not know that the time period synthetic kidney could not be prolonged to a small mechanical dialysis machine, and there are not any apparent references within the article that outline the utilization of the time period to strictly tissue-engineered organs. To me, it is smart to have each strategies of implementation below the identical article as they’re each completely different approaches for creating an synthetic kidney, be it made from tissue or plastic. I am all for explaining why neither sort exists but and the respective difficulties every implementation faces. Moreover, given how there may be comparatively little content material throughout all three articles, would not it make sense to synthesize the content material and current one full article that discusses all the present (and previous) makes an attempt (throughout all of the various approaches) at creating synthetic kidneys? Chaldor (speak) 20:12, 5 October 2008 (UTC)
I merged primarily based on what we had already agreed on — see Discuss:Wearable_artificial_kidney. We in all probability can merge within the different article too. Nephron  T|C 18:40, 1 November 2008 (UTC)

Hello, I want to make some adjustments to the purpose on AWAK that cartridge alternative shouldn’t be needed. IT is important after the cartridge is saturated with toxins faraway from the physique. Limjason (speak) 06:14, 4 November 2008 (UTC)

Splitting the article

I feel it is smart to separate the dialysis article into ‘hemodialysis’ and ‘peritoneal dialysis.’ I feel they’re very completely different. Any ideas? Nephron 02:43, 14 July 2005 (UTC)

I agree Dr B2 (speak) 08:24, 28 Might 2009 (UTC)

break up

as Nephron recommended above, I’m going to create two sub-divisions of HD and PD over the subsequent few daysHswapnil 18:40, 12 December 2005 (UTC)

Go for it… it’s one thing I have never gotten round to doing. Nephron 02:57, 16 December 2005 (UTC)
i agree … it should not be merged from th starting Dr B2 (speak) 08:26, 28 Might 2009 (UTC)

Intestinal dialysis

I’ve restored the deleted intestinal dialysis part. It was deleted for an invalid motive. That it’s “fringe” or represents a small share shouldn’t be a legitimate wikipedia excuse for a peer overview researched process. It could be an excuse for not having a separate article, however wikipedia articles are sometimes extra full than mere textbooks or desk references, and qualifying materials should not be excluded out of mere prejudice, since most new concepts begin out as fringe. Plate tectonics was fringe for a number of a long time earlier than it grew to become accepted within the Sixties. One fascinating factor about intestinal dialysis, is that as a non-invasive process, it may simply be used to complement and maybe enhance the outcomes of normal dialysis, or to delay the necessity for it.–68.35.3.66 (speak) 12:27, 15 August 2009 (UTC)

The every day metabolic load of fastened hydrogen ions

What’s “the kidneys take away from the blood the every day metabolic load of fastened hydrogen ions” within the first paragraph referring to? I do not discover something about this in Kidney.–Biologos (speak) 12:16, 5 October 2009 (UTC)

Within the meantime I discovered that that is nearly a word-by-word quote from http://www.kidneyatlas.org/book5/adk5-01.ccc.QXD.pdf (the present reference no. 1), and that it refers back to the so-called fastened acids. I modified the sentence into one thing that’s – hopefully – extra comprehensible.–Biologos (speak) 13:55, 2 November 2009 (UTC)

Including extra data to the Dialysis article

We want to add extra data to the introduction:

“For sufferers with stage 5, or Finish-Stage Kidney Illness (ESKD), the decline in kidney perform occurred over a interval of months to years till a stage was reached at which remedy was wanted for survival. In contrast to Acute Renal Failure (ARF) (Acute Kidney Harm (AKI)), can’t be cured or reversed and long-term therapies are wanted to interchange the misplaced features of the kidney. The remedy for ESKD that the majority naturally replaces misplaced kidney perform is a kidney transplant: http://en.wikipedia.org/wiki/Kidney_transplant]. Nevertheless, some sufferers aren’t good candidates for a transplant on account of medical or different causes, some can’t obtain a transplant due to the quick provide of donor kidneys, and others merely resolve {that a} transplant shouldn’t be the most suitable choice for them. In consequence, most sufferers with ESKD should depend on dialysis to interchange the water and waste removing features of the wholesome kidneys.”

We might additionally like so as to add extra clarification to the Rules part (our additions in daring):
Diffusion describes a property of drugs in water. Substances in water have a tendency to maneuver from an space the place they’re in a excessive focus to an space of low focus. Blood flows by one facet of a semi-permeable membrane, and a dialysate, or particular dialysis fluid is on the alternative facet. A semipermeable membrane is a skinny layer of fabric that accommodates numerous sized holes, or pores. Smaller solutes and fluid move by means of the membrane, however the membrane blocks the passage of bigger substances (for instance, crimson blood cells, massive proteins).
The 2 major varieties of dialysis, hemodialysis (HD) and peritoneal dialysis (PD), take away wastes and extra water from the blood in numerous methods. Hemodialysis removes wastes and water by circulating blood outdoors the physique by means of an exterior filter, known as a dialyzer, that accommodates a semipermeable membrane. (http://en.wikipedia.org/wiki/Hemodialysis]

And on the finish of Rules part we want to add:
In peritoneal dialysis, wastes and water are faraway from the blood contained in the physique utilizing the peritoneal membrane as a pure semipermeable membrane. Wastes and extra water transfer from the blood, throughout the peritoneal membrane, and right into a particular dialysis answer, known as dialysate, within the belly cavity which has a composition much like the fluid portion of bloodhttp://en.wikipedia.org/wiki/Peritoneal_dialysis).

Underneath Hemodialysis we want to add (our additions in daring):
In hemodialysis, the affected person’s blood is pumped by means of the blood compartment of a dialyzer, exposing it to a semipermeable membrane. The dialyzer consists of 1000’s of tiny artificial hole fibers. The fiber wall acts because the semipermeable membrane. Blood flows by means of the fibers, dialysis answer flows across the outdoors the fibers, and water and wastes transfer between these two options.

And below Dialysis we want to add (our additions in daring):
In peritoneal dialysis, a sterile answer containing minerals and glucose is run by means of a tube into the peritoneal cavity, the belly physique cavity across the gut, the place the peritoneal membrane acts as a semipermeable membrane. The peritoneal membrane or peritoneum is a layer of tissue containing blood vessels that strains and surrounds the peritoneal, or belly, cavity and the inner belly organs (abdomen, spleen, liver, and intestines).
Renaldialysis (speak) 17:39, 24 November 2009 (UTC)

Effectiveness of Dialysis

If anybody is aware of the topic, I might have an interest as to the effectiveness of dialysis versus regular kidney perform, and the effectiveness within the long-term. I’ve no data to supply, however only a suggestion if anybody is up for it! –postglock 05:43, 13 Jun 2005 (UTC)

As a former dialysis affected person, I can say it is a far cry from regular kidney perform. Medical doctors say you may stay on dialysis in idea perpetually, however I do know individuals who have died whereas on dialysis, on account of loosing fistula entry, and locations for fistulas. I used to be on peritoneal dialysis, and it is higher than hemo dialysis, however once more, not as efficient as a traditional kidney. –20px Spinboy 16:52, 13 Jun 2005 (UTC)

A superb standard dose of haemodialysis may very well be very roughly approximated to a glomerular filtration charge of 15 ml/min. Peritoneal dialysis is worse when it comes to small molecule clearance (equal to a GFR of round 8-10ml/min), however has the benefit of being a steady modality. It is usually really helpful that dialysis is commenced when the glomerular filtration charge of the native kidneys is <15ml/min, so its not surprising people don't feel better on dialysis, you're not greatly improving the kidney function, just mantaining a level compatible with survival. Of course if you could have daily overnight dialysis you'd achieve a respectible clearance perhaps equivalent to a GFR of around 35ml/min. Roughly "Normal" GFR >90ml/min/1.73m2 lowering by 0.9ml/min per yr after 40. John Prowle (speak · contribs).

Helpful documentation for this comparability will be discovered on p. 1 of Gabriel Danovitch, ‘Handbook of Kidney Transplantation’ (Philadelphia: Lippincott, 2001), the place he states that “probably the most environment friendly hemodialysis regimens presently present solely 10% tp 12% of the small solute removing achieved by two usually functioning kidneys.” This remark ought to be up to date, nonetheless, by reference to knowledge from the brand new applications of short- and long-daily residence hemodialysis carried out six days or nights every week, which enhance solute clearance, though nonetheless fall far wanting reaching what regular kidneys can do. Person: JP Marat —Previous unsigned remark added by 74.198.12.3 (speak) 19:29, 28 Might 2010 (UTC)

The primary couple of sentences ought to embody what dialysis is!

The article breaks instantly into what it’s used for with out saying that it’s a method to artificially change misplaced kidney perform—I can solely assume that is what it’s as a result of the article is so unclear. I am certain it is rather more helpful for an individual with a medical background however to the layperson this text is ineffective. —Previous unsigned remark added by 78.86.61.94 (speak) 18:07, 29 March 2011 (UTC)

PE and arterial illness

doi:10.1111/j.1538-7836.2012.04921.x – major examine in JTH displaying doubled threat of pulmonary embolism with a excessive standardised mortality ratio. JFW | [email protected] 14:28, 13 December 2012 (UTC)

This web page seems to duplicate the Hemodialysis web page. Since that’s the extra detailed web page, the contents of this one ought to be merged into it and this grow to be a redirect. — Previous unsigned remark added by 216.215.123.163 (speak) 18:40, 3 August 2015 (UTC)

Exterior hyperlinks modified

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Main? Secondary?

The article identifies some types of dialysis as “major” and others as “secondary”, however would not clarify the aim or significance of the excellence. — Previous unsigned remark added by 50.53.24.225 (speak) 23:32, 12 December 2015 (UTC)


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