How to write an essay on High-flux Creatinine Dialysis

How to write an essay on High-flux Creatinine Dialysis

Dialysis is a process through which excess fluids and electrolytes are removed from the body. This procedure is mostly indicated in patients with kidney failure who have a problem with the maintenance of an effective homeostasis of electrolytes and fluids in the body systems (Rafik et al., 2018). The clearance of solutes using a dialyzer during hemodialysis involves different process depending on the properties of the materials involved. These processes include diffusion and ultra-filtration and aims to remove waste products by passing a semipermeable membrane. The high-flux dialyzers are effective for eliminating moderate sized molecules between 10000 and 15000 Dalton such as lipids (Rafik et al., 2018).

Diffusion is the primary method for the removal of toxins such as creatinine during dialysis. It involves the movement of substances following a random movement down a concentration gradient and across a semi permeable membrane. Small sized toxins like creatinine which is in high concentration in blood move to the low concentration areas in the dialysate through diffusion (Shahbaz & Gupta, 2019). To control the movement of solutes during dialysis, an osmotic pressure is sustained to prevent pure solutes in the blood from going through the semi permeable membrane in the dialyzer.

Similarly, for the effective clearance of creatinine, there must be a transmembrane pressure. This is the difference in pressure between the dialysate fluid and the blood that is essential for pushing the filtered materials. The difference in pressure between fluids due to hydrostatic and osmotic forces enables the convective flow of excessive solutes and water via ultrafiltration (Shahbaz & Gupta, 2019). Optimal creatinine clearance requires an low transmembrane pressure which indicates a well-functioning membrane (Shahbaz & Gupta, 2019). Furthermore, the effectiveness of a membrane indicated by its permeability to water per unit surface area and pressure is its ultrafiltration coefficient.

The removal of excessive creatinine from blood is facilitated by the counter current flow of fluids in the dialyzer. Blood from the body is passed through an extracorporeal circuit membrane with dialysate flows in the opposite direction next to it. This countercurrent flow is crucial for reducing the concentration gradient between the fluids for optimal removal of creatinine (Rafik et al., 2018). Moreover, several factors influence the process of diffusion. These factors include the concentration gradient, the temperature and the surface area of the membranes separating different fluid in the dialyzer. Greater concentration of creatinine in the blood would enhance its diffusion to the dialysate with lower concentration (Shahbaz & Gupta, 2019). Besides, high temperatures are beneficial for increasing the kinetic forces of molecules hence speeding their motion during diffusion. Finally, a higher surface area of the dialyzer would raise the rate of diffusion of substances.

Clearance is the removal of substances during dialysis which is expressed as volume per unit time. The rate of clearance of wastes during high-flux dialysis is affected by the efficiency of the dialyzer, the flow rate of blood and the flow rate, volume, dwell time and composition of the dialysate (Wongrakpanich et al., 2017). Increasing any of these parameters have a resultant effect of enhancing clearance. However, studies have found that three sessions of hemodialysis per week are effective and efficient in removing excessive wastes and lowering mortality in patients with residual renal function. Besides, the optimal removal of creatinine is governed by the effectiveness of the dialyzer. According to Wongrakpanich et al. (2017), some of the factors which influence the performance of the dialysis machine generally resonate around the dialyzer membrane including its pore sizes, surface area, pore size distribution, wall thickness and its adsorptivity.

 

References

Rafik, H., Aatif, T., & El Kabbaj, D. (2018). The impact of blood flow rate on dialysis dose and phosphate removal in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation : An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 29(4), 872–878. https://doi.org/10.4103/1319-2442.239654

Shahbaz, H., & Gupta, M. (2019). Creatinine clearance. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544228/

Wongrakpanich, S., Susantitaphong, P., Isaranuwatchai, S., Chenbhanich, J., Eiam-Ong, S., & Jaber, B. L. (2017). Dialysis therapy and conservative management of advanced chronic kidney disease in the elderly: A systematic review. Nephron, 137(3), 178-189. https://doi.org/10.1159/000477361

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