The kidneys function is to filter out wastes and excrete fluid when the pressure of blood in the bloodstream for

An access site to the blood stream must be present in order for the blood to circulate through the equipment of the dialysis machine. Large-bore needles are inserted into artificially dilated veins in the forearms. The veins dilate due to the "surgical construction of artificial fistula" (Baillod, 1995, p.17). Inserting these needles is the most complicated and mentally and physically demanding task for the patient, yet almost all patients learn to do this. In some uncommon cases where the patient cannot stand needles, another method to access the blood stream has to be developed. (Baillod, 1995)

The cost for home dialysis and hospital dialysis are relatively identical if viewed from a short term treatment perspective. In the hospital, money must be spent on staff and the use of equipment, and at home the money must be spent to purchase a haemodialysis machine which costs about $30,000. (Baillod, 1995)

Haemodialysis is a process which occurs outside the body. (Mallick, 1999) It was first successfully used in 1945. There are around 250,000 people receiving haemodialysis in the United States, and over one million world wide. (Hutter,2000) Patients may receive haemodialysis at a hospital by doctors and staff, or at home which is done by themselves, relatives, or family members. As a result of financial reasons, lack of trained staff, and limited space in the hospital, the most practical and economical method is home treatment. The patient's home provides the necessary room for the equipment, and since there is little hospital staff trained to handle and perform haemodialysis it makes no difference to train the staff or the family members. The treatment has become available for home use since 1964. Doctors also found that home dialysis gave a much better rehabilitation rate because the patient felt more relaxed and comforted by familiar surroundings. (Baillod, 1995)

In order for the haemodialysis process to work effectively, "anticoagulant" (Janssen, 1996.p198) drugs must be administered to the patient. The need for these drugs is so that the blood does not clot during the process, leading to closing of the fistula. Aspirin is prescribed to the patient so that the fistula do not close during the course of the day, and heparin is injected into the blood stream so that clotting does not occur mid-process. (Janssen, 1996)

ces blood through the internal structures of the kidney. Decreased blood flow is one cause of damage to the kidneys and may occur when there is extremely low blood pressure (hypotension) from trauma, complicated surgery, septic shock (toxin or bacterial waste infection like those excreted by E-coli), hemorrhage to arteries and veins, burns and dehydration. Other causes of kidney failure are acute tubular necrosis which is the damage of kidney cells due to a lack of oxygen. This may occur after toxic injury to the kidneys when they have been exposed to metals, solvents, certain antibiotics and other medications. Also, Myoglobinuria may cause damage to kidney tissue. This may be caused by rhabdomyolysis which results from a crushing injury. Myoglobin is an iron-containing pigment in skeletal muscle. When this muscle is damaged, myoglobin is released into the bloodstream, which is then filtered out by the kidneys. Myoglobin breaks down into potentially toxic compounds which may harm the kidneys. Acute renal failure may also result from direct injury to the kidney, infections, and kidney stones which result from high concentrations of urine in the kidneys, which allows substances in the urine to crystallize and form stones. Other causes include blood disorders, such as idiopathic thrombocytopenic purpura (ITP) which results from the lymph tissues producing antibodies against platelets causing bleeding and lowering the blood pressure. (Janssen, 1996)

The best method for renal replacement is to get a kidney replaced, but since the demand and supply of healthy kidneys is so unbalanced

Some common words found in the essay are:
Hutter2000 Patients, Cuprophan Instead, Haemodialysis Thousands, ANP Uusimaa1999p25, Treatments ESRF, baillod 1995, blood pressure, hoenich 1995, mallick 1999, baillod 1995 p19, synthetic membranes, 1995 p19, renal failure, white blood, white blood cells, amount fluid, blood stream, acute renal failure, weight baillod 1995, health patients taught,
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