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Book initiates with introductory material to hemodialysis technology and its historical evolution and later on divulging into the field of biomaterials. With this background, the book discusses selection criteria of a suitable biomaterial for synthesis of haemodialysis membranes along with illustration of a complete indigenous, low cost technology for spinning of haemodialysis fibres. Well illustrated description of instruments used for membrane characterization and biomedical engineering is also provided at suitable junctures to effectively present the concept including worked out examples. Present title can be a good textbook as well as a research material for membrane as well as biomedical engineering curricula and provides coverage for appropriate undergraduate and graduate students interested in hemodialysis membranes.
Membrane technologies are currently the most effective and sustainable methods utilized in diversified water filtration, wastewater treatment, as well as industrial and sustainable energy applications. This book covers essential subsections of membrane separation and bioseparation processes from the perspectives of technical innovation, novelty, and sustainability. The book offers a comprehensive overview of the latest improvements and concerns with respect to membrane fouling remediation techniques, issues of bioincompatibility for biomedical applications, and various subareas of membrane separation processes, which will be an efficient resource for engineers.
The present book contains the Proceedings of a two day Symposium on Uremic Toxins organized at the University of Ghent in Belgium. A series of guest lectures, free communications and posters have been presented. An international audience of 163 scientists from 16 nationalities listened to and discussed extensively a spectrum of topics brought forward by colleagues and researchers who worked for many years in the field of Uremic Toxins. There is a striking contrast between all the new dialysis strategies available in the work to "clean" the uremic patients and the almost non-progression of our knowledge on uremic toxins in the past decade. In this sense the symposium was felt by all participants as a new start for the research in the biochemical field of the definition of uremia. If the present volume would stimulate new work in this field in order to define uremia, or identify the uremic toxins, the purpose of the organizers would be maximally fulfilled.
Despite constant significant advances, cardiovascular as well as more general outcomes of hemodialysis treatment remain unsatisfactory. The introduction of innovative 'high retention onset' membranes has led to the development of a new treatment modality called 'expanded hemodialysis' (HDx), which is the focus of this book. This new therapy is likely to benefit end-stage kidney disease patients, thanks to enhanced removal of molecules retained by current dialysis techniques. HDx is simple to set up and application does not require special hardware or specific nursing skills. This book contains emerging evidence and fascinating new hypotheses on HDx. It is highly recommended for all physicians and healthcare professionals who are caring for dialysis patients and are seeking innovation and improved care solutions. It will also be of considerable interest to students and fellows.
A comprehensive summary of high-flux dialyzers and their properties Dialyzers today are developed with high permeability and biocompatibility in mind, even though the definition of these so- called high-flux dialyzers remains controversial. In the Japanese reimbursement system, dialyzers are divided into five types, ranging from I to V, in accordance with their clearance for beta2- microglobulin (beta2-MG). Classes IV and V (beta2-MG clearance greater or equal to 50 and 70 ml/min, respectively, at a blood flow rate of 200 ml/min) are the most common ones, used in more than 90% of Japanese dialysis patients. Membranes used in types IV and V dialyzers are called high-performance membranes (HPMs) and are characterized by an exceptionally high flux rate, permeability and biocompatibility. The book at hand covers all aspects of these HPM dialyzers, including their definitions and characteristics, clinical experiences and basic investigations. Moreover, historical HPMs and several membranes with special characteristics that are not categorized into classes IV or V are discussed. Providing a summary of commercially available HPM dialyzers, this publication not only serves as a textbook for those interested in state-of the-art dialysis treatment, but is also a concise database of the products available.
The number of dialysis patients, and their ages, continues to increase globally. This creates major issues such as rising medical costs in an aging population, how to best manage end-of-life care, and how to train the various practitioners involved in dialysis care. After the US and China, Japan occupies 3rd place with regard to the number of dialysis patients and is also widely regarded as a world leader in dialysis. This book contains selected articles – organized into 4 chapters - that discuss recent advances in dialysis therapy in Japan. Chapter 1 presents insights into causes, risk factors, disease associations, and possible implications for management of dialysis patients. Chapter 2 examines recent progress in hemodialysis treatment, and chapter 3 focuses on developments in peritoneal dialysis. The final chapter concentrates on recent advances in apheresis and current trends in practice, among other topics. This book is aimed at nephrologists, physicians, urologists, nurses, clinical engineers, pharmacists, and nutritionists. It is a significant contribution to furthering the progress of dialysis therapy worldwide.
Nolph and Gokal's Text Book of Peritoneal Dialysis, Third Edition, covers advances made in the field for the past 30 years. During the past two decades, the time during which this therapy has been increasingly utilized, this text has continued to be recognized as the major source of the discipline's base knowledge. The evolution of this text to its newest edition parallels the growth of peritoneal dialysis from Continuous Ambulatory Peritoneal Dialysis in the eighties to the current therapy that encompasses manual and automated therapies with full emphasis on adequacy of dialysis dose. Peritoneal dialysis represents an intracorporeal technique for blood purification. This unique dialysis system represents one of many human attempts to manipulate nature for sustenance of life. The past few years of advances have focused on further improvement of the technique. Areas that have fueled the interest of researchers include: (1) Physiology of high transporters (and the role of genetics and inflammation); (2) Continued debate over the most appropriate adequacy indices (small solute clearances, large solute clearances, clinical assessment etc.); (3) Understanding, preventing and treating the MIA syndrome in PD patients ( including the roles of leptin, and adiponectin); (4) Pathogenesis and newer management strategies of vascular calcification; (5) Continued improvements in infectious complications including peritonitis; (6) Further improvements in catheter technology; (7) Automated techniques; (8) Explaining and correcting PD underutilization; (9) Rationale and applications of newer dialysis solutions; (10) New understanding and approaches to management of osteodystrophy; (11) Refinements in anemia management including new insights in iron metabolism in PD patients; (12) Further definition of indications for PD; (13) The ideal time to initiate dialysis. Newer insight into host defense mechanisms have also made the past decade of advances in the field more meaningful for clinicians. This text also covers the knowledge gained from animal models of peritoneal dialysis. Nolph and Gokal's Textbook of Peritoneal Dialysis, Third Edition is a compilation of the latest knowledge in the field. It cites and describes in great detail, the new discoveries and the evolution of understanding the subject of these discoveries.
This book is an evidence-based review of the practical challenges of dealing with patients receiving dialysis. The first section covers technical and procedural considerations such as choosing the hemodialysis membrane and choosing the best dialysis option. The second section covers clinical considerations such as infection and the treatment of specific renal disease complications. The book includes numerous illustrations and tables and drug charts for dialysis patients. This edition's current outcomes chapter has been expanded to include patient depression and improving quality of care. New chapters cover dialysis in the ICU, valvular heart disease, and pre-emptive renal transplantation.
On-line HDF represents a major technical development in the delivery of hemodialysis therapy: It combines the properties of increased diffusion available in current high-flux membranes with convective removal of between 6 and 30 liters per treatment and requires the use of ultrapure water and online filtration of replacement fluid. On-line HDF has been successfully introduced in Europe and Asia and is routinely prescribed for dialysis patients in these regions.The book at hand summarizes the history and achievements of on-line HDF in four parts: A report of the technological development in both machine and fiber/dialyzer is followed by a description of the challenges encountered in the evolution of on-line HDF, collecting the accounts of clinical key opinion leaders who had been involved in its early application. The third part presents a comprehensive review of the clinical results achieved with on-line HDF from its inception to the present times, in which it represents the clinical golden standard. The fourth and final part is dedicated to on-line HDF as a ‘vision’ for the future.
A concise handbook on clinical and technical possibilities The application of hemodiafiltration has been restricted until recently, when a broader clinical application has been made possible due to evidence from large studies and clinical investigations. This book provides an updated review of the evolution, advances and recent results achieved by hemodiafiltration in the clinical arena. The first part is devoted to historical notes and an outline of the evolution of different forms of hemodiafiltration, made possible by technological developments in the fields of membranes, machines and fluids. The next section describes the theoretical rationale for hemodiafiltration, providing a detailed analysis of the involved mass separation processes, the hydraulic properties of the dialyzers, fluid mechanics and crossfiltration in hollow fiber hemodialyzers. An outline of different hemodiafiltration techniques, also reporting peculiar transport mechanisms and related technology, is given next, and a section on the clinical effects of hemodiafiltration concludes this book. Including different technologies, the publication offers a complete overview of the technical and clinical possibilities provided by hemodiafiltration in its widest concept, ranging from the molecular basis to the most practical application. It will be a valuable tool for the implementation of hemodiafiltration in daily practice aimed at beginners and experts, scientists and physicians, students and senior faculty members alike.