In medicine, Dialysis (from Greek dialusis,"", meaning ''dissolution'', dia, meaning ''through'', and lysis, meaning ''loosening or splitting'') is a process for removing waste and excess water from the blood and is used primarily as an artificial replacement for lost kidney function in people with kidney failure. Dialysis may be used for those with an acute disturbance in kidney function (acute kidney injury, previously acute renal failure) or progressive but chronically worsening kidney function—a state known as chronic kidney disease stage 5 (previously chronic renal failure or end-stage renal disease). The latter form may develop over months or years, but in contrast to acute kidney injury is not usually reversible and dialysis is regarded as a "holding measure" until a kidney transplant can be performed or sometimes as the only supportive measure in those for whom a transplant would be inappropriate.〔Pendse S, Singh A, Zawada E. Initiation of Dialysis. In: ''Handbook of Dialysis''. 4th ed. New York, NY; 2008:14–21〕
The kidneys have important roles in maintaining health. When healthy, the kidneys maintain the body's internal equilibrium of water and minerals (sodium, potassium, chloride, calcium, phosphorus, magnesium, sulfate). The acidic metabolism end-products that the body cannot get rid of via respiration are also excreted through the kidneys. The kidneys also function as a part of the endocrine system, producing erythropoietin and calcitriol. Erythropoietin is involved in the production of red blood cells and calcitriol plays a role in bone formation.〔Brundage D. ''Renal Disorders''. St. Louis, MO: Mosby; 1992〕 Dialysis is an imperfect treatment to replace kidney function because it does not correct the compromised endocrine functions of the kidney. Dialysis treatments replace some of these functions through diffusion (waste removal) and ultrafiltration (fluid removal).〔(【引用サイトリンク】title=Atlas of Diseases of the Kidney, Volume 5, Principles of Dialysis: Diffusion, Convection, and Dialysis Machines )〕
A Dutch physician, Willem Johan Kolff, constructed the first working dialyzer in 1943 during
the Nazi occupation of the Netherlands.〔''Willem Kolff, Doctor Who Invented Kidney and Heart Machines, Dies at 97''. http://www.nytimes.com/2009/02/13/health/13kolff.html?pagewanted=all; New York Times, 2009〕 Due to the scarcity of available resources, Kolff had to improvise and build the initial machine using sausage casings, beverage cans, a washing machine, and various other items that were available at the time. Over the following two years, () Kolff used his machine to treat 16 patients suffering from acute kidney failure, but the results were unsuccessful. Then, in 1945, a 67-year-old comatose woman regained consciousness following 11 hours of hemodialysis with the dialyzer, and lived for another seven years before dying from an unrelated condition. She was the first-ever patient successfully treated with dialysis.〔
Dr. Nils Alwall modified a similar construction to the Kolff kidney by enclosing it inside a stainless steel canister. This allowed the removal of fluids, by applying a negative pressure to the outside canister, thus making it the first truly practical device for hemodialysis. Alwall treated his first patient in acute kidney failure on September 3, 1946.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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