Hole's Human Anatomy and Physiology   8/e   Shier/Butler/Lewis
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Kidney Dialysis

Urinary

The artificial kidney (renal dialysis machine) is a machine used to treat patients suffering from renal failure. The use of this machine often allows people with severe acute renal failure to recover without developing the side effects of renal failure, and the machine can substitute for the kidneys for long periods of time in people suffering from chronic renal failure.

Renal dialysis is based on blood flow through the tubes composed of a selectively permeable membrane. On the outside of the dialysis tubes is a fluid that contains the same concentration of solutes as the plasma, except for the metabolic waste products. As a consequence, a diffusion gradient exists for the metabolic waste products from the blood to the dialysis fluid. The dialysis membrane has pores that are too small to allow the plasma proteins to pass through them. Because the dialysis fluid contains the same beneficial solutes as the plasma, the net movement of these substances is zero. In contrast, the metabolic waste products diffuse rapidly from the blood into the dialysis fluid.

Blood usually is taken from an artery, passed through tubes of the dialysis machine, and then returned to a vein. The rate of blood flow is normally several hundred milliliters per minute, and the total surface area of exchange in the machine is close to 10,000 to 20,000 cm2.

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