An extension of the method makes possible the separation of mixed colloids by the use of a semipermeable membrane (usually synthetic) of known selectivity, i.e., one that will permit the diffusion of one colloid and hinder the diffusion of others. Mixed macromolecules, such as proteins, may be similarly separated. By the use of graded semipermeable membranes chosen to allow successively smaller molecules to pass, mixtures can be separated into components of graded ranges of molecular weight.
Artificial kidney machines have been developed that make use of dialysis to purify the blood of persons whose kidneys have ceased to function. Known as hemodialysis, this procedure has saved the lives of many persons suffering from renal failure. In such machines, blood is circulated on one side of a semipermeable membrane (often cellophane) while a special dialysis fluid is circulated on the other side. The dialysis fluid must be a solution that closely matches the chemical composition of the blood. Metabolic waste products such as urea and creatinine diffuse through the membrane into the dialysis fluid and are discarded, while loss by diffusion of substances necessary to the body (such as sodium chloride) is prevented by their presence in the dialysis fluid.
In peritoneal hemodialysis, the dialysis fluid is introduced into the abdominal cavity. Waste products leach from the blood vessels into the fluid, which is later drained from the patient. Home peritoneal dialysis machines that release patients from dependence on hospital dialysis (usually three 4-hr visits weekly) have been available since the 1980s. See diffusion.
In medicine, dialysis (from Greek "dialusis", meaning dissolution, "dia", meaning through, and "lusis", meaning loosening) is primarily used to provide an artificial replacement for lost kidney function (renal replacement therapy) due to renal failure. Dialysis may be used for very sick patients who have suddenly but temporarily, lost their kidney function (acute renal failure) or for quite stable patients who have permanently lost their kidney function (stage 5 chronic kidney disease). When healthy, the kidneys maintain the body's internal equilibrium of water and minerals (sodium, potassium, chloride, calcium, phosphorus, magnesium, sulfate) and the kidneys remove from the blood the daily metabolic load of fixed hydrogen ions. The kidneys also function as a part of the endocrine system producing erythropoietin and 1,25-dihydroxycholecalciferol (calcitriol). Dialysis is an imperfect treatment to replace kidney function because it does not correct the endocrine functions of the kidney. Dialysis treatments replace some of these functions through the diffusion (waste removal) and convection (fluid removal).
In hemodialysis, the patient's blood is pumped through the blood compartment of a dialyzer, exposing it to a semipermeable membrane. The cleansed blood is then returned via the circuit back to the body. Ultrafiltration occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is done by applying a negative pressure to the dialysate compartment of the dialyzer. This pressure gradient causes water and dissolved solutes to move from blood to dialysate, and allows removal of several litres of excess fluid during a typical 3 to 5 hour treatment. In the US, hemodialysis treatments are typically given in a dialysis center three times per week (due in the US to Medicare reimbursement rules), however, as of 2007 over 2,000 people in the US are dialyzing at home more frequently for various treatment lengths. Studies have demonstrated the clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. These frequent long treatments are often done at home, while sleeping but home dialysis is a flexible modality and schedules can be changed day to day, week to week. In general, studies have shown that both increased treatment length and frequency are clinically beneficial.
In intestinal dialysis, the diet is supplemented with soluble fibres such as acacia fibre, which is digested by bacteria in the colon. This bacterial growth increases the amount of nitrogen that is eliminated in fecal waste. An alternative approach utilizes the ingestion of 1 to 1.5 liters of non-absorbable solutions of polyethylene glycol or mannitol every fourth hour.