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Solute transport mechanisms in dialysis

  • Chapter
Replacement of Renal Function by Dialysis

Abstract

The immediate goal of renal replacement therapy is to prevent accumulation of toxic solutes in the patient’s tissues by removing them from the blood. Artificial kidneys accomplish this by dialyzing and filtering the blood across semipermeable membranes, taking advantage of the natural forces of diffusion and convection. Native kidneys combine filtration at the glomerulus with selective reabsorption across the tubule. To allow movement of solute in the absence of a concentration gradient and to permit passage of water-soluble solutes through the lipid bilayers of tubular membranes, reabsorption of most solutes requires facilitated pathways. Reabsorption across native kidney tubules is therefore much more solute-specific than the relatively nonselective diffusion and convection across inert membranes of artificial kidneys, and the reabsorptive process works in reverse, conserving desirable solutes instead of removing unwanted solutes.

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Authors
  1. Thomas Depner
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  2. Laurie Garred
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Editors and Affiliations

  1. Division of Nephrology, Department of Medicine III, University of Vienna, Währinger Gurtel 18-20, A-1090, Vienna, Austria

    Walter H. Hörl

  2. Division of Nephrology, Centre for Internal Medicine and Dermatology, Medizinische Hochschule, Hannover, Germany

    Karl M. Koch

  3. Optimal Dialysis Research Unit, London Health Sciences Centre and The University of Western Ontario, London, Ontario, Canada

    Robert M. Lindsay

  4. Department of Nephrology, St. Bortolo Hospital, Viale Rodolfi, I-36100, Vicenza, Italy

    Claudio Ronco

  5. RenalTech International, LLC, 320 East 65th St, #116, New York, NY, 10021, USA

    James F. Winchester

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Depner, T., Garred, L. (2004). Solute transport mechanisms in dialysis. In: Hörl, W.H., Koch, K.M., Lindsay, R.M., Ronco, C., Winchester, J.F. (eds) Replacement of Renal Function by Dialysis. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2275-3_4

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