La dialyse

ATEM  France
March 05 2021, 07h48 PM -France-         1 618 033

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What is the hemodialysis ?



The "Renal insufficiency" is a term that designates the more or less significant deterioration of the functioning of both kidneys. During the 1950s, some dialysis centers had "artificial kidneys" to treat water-electrolyte balance, but not end-stage renal failure. This disease was therefore fatal until before the 1960s. This new "hemodialysis" technique was still very rudimentary. Then he implemented very heavy systems, with demanding manipulations. Hemodialysis times of 12 hours every 2 days were very frequent and painfully tolerated. The great technical and medical progress allowed an extremely rapid progression of the number of treatments as well as a better tolerance (children, elderly). Since then, hemodialysis has become much safer and thus it has also been able to reach the patient's home, offering them a better quality of life. Dialysis is also a mandatory preparatory phase for kidney transplantation.

Here is a small link to a simple video to understand what dialysis is. Click here !
You can find a lot of videos or documents, on YouTube for example, dealing with the theme of dialysis..





Today, a dialysis session lasts about 4 hours. The hemodialysis machine has a pump that draws blood from the patient at a controlled rate, allowing it to pass through a filter called a dialyzer. The pumped blood is returned to the patient immediately after leaving the dialyzer. In addition to the blood access (inlet / outlet) it has another connection (inlet / outlet) that allows the supply of a liquid (the dialysis liquid) of a certain composition, generated by the machine. Blood and dialysis fluid are separated by a thin semi-permeable membrane that acts as a filter. It is perforated with microholes that can only borrow very small particles. Therefore, neither blood cells or (larger) bacteria can pass through it. Only water and very small substances can be removed. The dialysis fluid is responsible for extracting these elements and directing them to the sewer. Thus the purification of the blood is carried out.
A patient with kidney failure can also undergo treatment at home, if desired. A large number of medical associations in France allow access to this complex technique at home. They allow all patients to receive high-quality hemodialysis or peritoneal dialysis treatment, at home or in a self-dialysis unit. These associations use dialysis techniques that are always at the forefront of progress. They are constantly investing for the safety and comfort of their patients.





The Hemodialysis is possible thanks to a vascular access located in the patient's forearm, called "fistula." This operation, performed by the urologic surgeon, connects a vein to an artery. As a result, the vein is enlarged following the blood flow that has become significantly more important (visible in the photo on the right). Dialysis nurses can thus take advantage of the flexibility of this dilated vein to place the two needles used to draw and return the blood to be treated. Healing after treatment is also faster. A fistula is not the only vascular access possible to dialyze a patient, but it is by far the most widely used.



Water treatment for hemodialysis is a very important link in the technical chain, whether the care is provided at the patient's home or in a hospital. The material involved is just more or less imposing. All this equipment must ensure that all unwanted microelements found in tap water are removed : chlorine, calcium, magnesium, aluminum, all bacteria (aerobic and anaerobic). Bacteriological and physicochemical samples are carried out periodically along the chain, and must be quickly sent to a laboratory, in order to know the quality of the water.



Example of water treatment for a hemodialysis center


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