Module 4

I learned in this module that the water should be treated before it can be used in HD since it has direct contact with the blood of the patient and can be fatal if it has contaminants. Dialysis technologist checks that water in the institution to make sure it will pass in the minimum standards that are set and for quality control.

Acetate dialysate is not used anymore due to the fact that it can cause hypotension even it is convenient for the institution to use it. It has a long shelf life and not prone to contamination.

What is now used is bicarb dialysate because it improves cardiac instability since bicarbonate is immediately available as physiologic buffer.

The 3 components of dialysate are acid concentrate, bicarbonate concentrate, and treated water.

Module 5

I learned in this module blood has higher concentration compared to dialysate that is why with the use of dialyzer, the molecules can move back and forth. Factors that can affect the movement of these molecules are their size, surface area, thickness, size, and number of pores in dialyzer, temp., and concentration of solutes in the blood.

Factors that can affect the clearance are permeability of the dialyzer, flow rate, UF rate, and concentration gradient.

Another thing that I learned in the module also is that only the small size molecules can pass the dialyzer (artificial kidney) that is why RBC, WBC, and platelets are not able to penetrate across the member because they have bigger size compared to solutes (creatinine, urea, glucose, phosphate) <500 daltons.

The formula for UFR = volume to be removed/treatment time

Dialyzer has 4 ports. 2 end ports for blood and 2 side ports for dialysate.