ALAZHAR UNIVERSITY

Faculty of Engineering

Medical Device Department

Lec.2 Hemodialysis Machine

Eng. Qasem Alyazji
Hemodialysis Machine
 Outlines ::
• Medical Background
• Concepts of Hemodialysis
• Hemodialysis Machine
➢ Dialyzer (Artificial Kidney)
➢ Dialysate
➢ Blood Circulation

• Monitoring & Control of Hemodialysis

Machine
• Safety in Field
:: Anatomy of the Kidney
Urinary system consists of :
Aorta

• Two Kidneys Renal vein

• Two Ureters Kidney
• Bladder Renal artery
• Urethra Vena cava
Ureter

Bladder

Urethra
:: Our kidneys
• The kidneys are reddish Fibrous Capsule
brown in colour.
• Ovoid shaped.
Renal Artery
Renal Vein
• Approximately 10cm in
length, 5cm in width, 2.5
cm in thickness and
weight between 115 to 170g
in the adult human. Pelvis
Pyramid (Medulla)
Ureter
• The left kidney lies a few
centimeters higher than the
right.
KIDNEYS
 Kidneys
remove waste products
from your body
FOOD
=
• Proteins
• Fats
• Starches
• ...
 Kidneys
Maintain the right remove
amount of water in the body
excess fluid
from your
body
 Kidneys
balance the minerals and
chemicals in your body
 Kidneys
control your
blood pressure

RENIN
 Kidneys
help the body produce
red blood cells

Erythropoietin
hormone
Kidneys help maintain
healthy bones

VITAMIN
D
Ca++
:: Functions of the Kidney Physiology)
• Kidney remove waste product (waste metabolizes)
• Kidney remove excess fluid in the body

• Balance the minerals and chemicals in the body

• Kidney help to control blood pressure
• Kidney help the body to produce red blood cell

• Kidney help maintain healthy strong bones

 :: How to work kidneys
• Blood enters the kidney from renal
artery, which branches into smaller
vessels that give rise to the glomerulus.
• After the filtered blood leaves the
glomerulus, it passes into an efferent
arteriole.
• Blood then drains into venous system
(Renal vein)
Outer membrane

Renal artery
‫الشريان الكلوي‬
Nephrons
Renal Vein (2 million)

‫الوريد الكلوي‬ Pelvis

Cortex

Medulla organised
Ureter
in pyramids

Urine
 :: Kidney Disease (Pathology)
The most common causes of kidney Failure:

Others
Congenital Diseases
‫امراض خلقيه‬ Diabetes mellitus

Systemic Diseases

Nephrosclerosis
‫التهاب الكلي‬
 Blood tests and urine tests
are the only way to know the
kidneys are damaged

blood tests A urine test

to check how well your kidneys are filtering can check for albumin in your urine.
:: Kidney Disease (Blood tests)
Glomerular filtration rate (GFR)
Failure kidney • Is the best indicator of how well the kidneys are
working.

GFR Plasma
ml/min creatinine
mol/L
Kidneys function Kidneys
less than 10% no longer function
of normal at all

Dialysis
End stage
kidney disease OR

Trans- plantation
:: Treatment Options
In the case of renal failure, there are today three treatment options:

Hemodialysis Peritoneal Dialysis Kidney Transplantation

What is Peritoneal Dialysis?

▪ Just like in Hemodialysis, Peritoneal

Dialysis (PD) uses a filter to clean the
blood and remove excess fluids

▪ For PD, a tube called a catheter is

surgically placed through the wall of
your abdomen as a permanent
access for PD

▪ Solution is placed in the abdomen in

contact with the peritoneal membrane
for several hours

▪ Waste and fluids pass through the

filter, then the solution and waste are
drained from your abdomen
Concepts of Hemodialysis
:: Diffusion
Definition

Diffusion is defined as the movement of solutes from a higher solute

concentration to a lower solute concentration area. These cups, where
the solutes are represented by black dots illustrate the principle.
Observe how the initial concentration gradient is gradually eliminated
as the solutes spontaneously spread in the fluid.
 :: Ultrafiltration
Ultrafiltration: The movement of fluid through a membrane caused
by a pressure gradient.

a) positive pressure b) negative pressure

Ultrafiltration is the process in which fluid is transported through a semi-

permeable membrane. The driving force is a pressure gradient across a
membrane which can be created in different ways:
a) a positive pressure on the b) a negative pressure on the
left compartment, represented right compartment, will
by the large arrow, will “push” “suck” fluid through the
fluid through the membrane. membrane.
 :: Transport Principles in HD
A pressure gradient is created
The blood contains waste across the dialysis membrane to
products and excess fluid. remove fluid by ultrafiltration.

fluid removal

start result

Because of the concentration

gradient between blood and solute removal The blood is cleaner, i.e.
dialysis fluid, the solutes will contains less diffusible waste
move across the membrane by products, and the blood
diffusion. volume is normalised.
Vascular Access (How is blood removed and replaced)

Type of vascular access in hemodialysis machine:

– Arterio-venous (AV) Fistula
– Arterio-venous graft
– Temporary Catheters
 Vascular Access (AV fistula & AV graft)

Venous Arterial
Line Line
▪ A “Fistula” is the surgical
linking of an artery to a vein
providing access to blood
vessels
Vein Artery

▪ A “Graft” is tubing surgically Radial Artery Graft

placed under the skin, linking

an artery to a vein

Vein
Vascular Access (Temporary Catheters)

• Dual lumen catheter placed into a

central vein-subclavian or
femoral.
• Advantages
– immediate use
– no needle sticks
• Disadvantages
– high incidence of infection
– poor flow-inadequate dialysis
– clotting
 :: Hemodialysis Machine)

In Hemodialysis the blood is

filtered using a special dialysis
machine, blood removed from
the body through a blood vessel
travels through tubes into the
dialysis machine, the machine
filters out wastes and extra
fluids, the newly cleaned blood
flows through another set of
tubes and back into the body.
:: Hemodialysis System
blood circuit fluid circuit

Dialyzer

This flow diagram shows the extracorporeal circuit during a

haemodialysis treatment. In the blood circuit (left) the blood is
pumped through the dialyzer. In the fluid circuit (right) the dialysis
fluid is prepared and pumped through the dialyzer.
:: Hollow Fiber Dialyzer)
Dialysate
Bundle of Inflow
Capillaries in
the Housing

Blood
Outflow
Dialysate
Outflow
Solute Transfer
across the
Capillary Walls
Blood
Inflow

The dialysate flows outside of the capillaries,

blood within the capillaries countercurrently.
Dialysate Circuit Outline

The main components of the dialysate circuit include:

– Dialysate proportioning system
– Dialysate formulation
– Ultrafiltration: Volumetric and flow-sensor control
– Dialysate disinfection and rinsing
– Monitors and control
 :: The Pressure Profile
pressure

• This pressure

positive
profile illustrates
how the pressure
varies in the blood
circuit.
• Note the high
negative

pressure drop in
the fistula
needles; this
results in a low,
sometimes even
negative, arterial
pressure. clamp Blood pump dialyzer clamp