Fresenius Group Overview

Dialysis

Dialysis treatment with the 5008 therapy system.

More than 3 million people suffer from chronic kidney failure around the world. The kidneys of these patients are unable to filter metabolic toxins and excess water from the blood for excretion through the urine. About 2.8 million patients rely on regular, life-saving dialysis treatment – either at a dialysis clinic or at home – to prevent the damage of further organs these toxins can cause when they accumulate in the blood.

When the kidneys fail, the whole body suffers. As the organs’ ability to filter the blood begins to fail, an excessive amount of protein is often excreted through the urine. The body then lacks this protein. In addition, edemas (retained water) can form in the legs or lungs. In many cases, an insufficient amount of toxins is also removed. These then collect in the blood and can damage other organs. Problems in the digestive tract can appear and even lead to bleeding ulcers. The toxins can even disturb the rhythm of the heart or lead to infection in the pericardium (heart sac). Nervous system disorders have also been observed.

The number of patients with chronic kidney disease grows five to six percent each year. This is primarily due to a longer life span, which increases the chance of kidney disease. In addition, the treatment of kidney patients in many developing countries is improving. The constantly increasing rates of high blood pressure and diabetes – the main causes of chronic kidney failure – also play a role.


  • Learn more about the function of the kidney
    What the kidneys do

    The human kidney is a small biological miracle with an intriguing design and function. It plays a vital role in the body since it is a significant part of the metabolic process. Kidneys come in pairs and are each about eleven centimeters long in an adult and weigh an average of 160 grams.

    Kidneys remove excess water and detoxify the body

    The kidneys create urine, which is excreted through the urinary tract. The urine is also used to remove excess water from the body as well as many toxins. The organs also regulate the acid-base balance in the body, preventing the acidification of the blood.


    Kidneys control vital bodily functions

    Kidneys also play a key role in the regulation of blood pressure. This is controlled by various hormones that are produced in the kidneys. Another hormone produced by these organs is Erythropoietin, which controls the production of red blood cells in the bone marrow. In addition, the kidneys also adjust calcium levels and play an important part in the production of vitamin D, which contributes to strong bones.


Types of dialysis
The basic differences between the two types of dialysis treatment are as follows:
  • Hemodialysis accounts for about 89 percent of all dialysis therapies. In hemodialysis, blood is filtered outside the patient’s body using an artificial kidney (dialyzer). The patient’s circulation is monitored and controlled by a dialysis machine.
  • The lining of the abdominal wall, known as the peritoneum, can also be used as a natural filter for dialysis. This type of dialysis is known as peritoneal dialysis and was used in the treatment of about 270,000 patients at the end of 2013.

A kidney transplant is the third treatment option for patients with chronic kidney failure. However, there is a very limited supply of donor organs. About 675,000 renal patients around the world live with a donor kidney.

  • Hemodialysis

    Modern technology replaces vital kidney functions

    Most patients with chronic renal failure receive treatment at a dialysis clinic three to four times a week – either in a dialysis clinic or at home. Modern technology replaces vital kidney functions during treatment. A dialysis machine pumps blood from a special vascular access in the lower arm of the patient into a dialyzer, the so-called artificial kidney. The dialyzer filters metabolic waste products and removes excess water from the blood. These waste products are then flushed out with dialysis solution and the filtered blood is returned to the patient’s body.


    While the blood is cleaned inside the dialyzer, the dialysis machine monitors the circulation of blood outside the body and controls the composition of the dialysis fluid. Furthermore, it pumps blood and dialysis solution through the dialyzer in two separate circuits. Anti-coagulants are also added to the blood to prevent it from clotting.

  • Peritoneal Dialysis

    The lining of the abdomen is used as a dialysis membrane in peritoneal dialysis


    In peritoneal dialysis, the lining of a patient’s abdominal cavity – the peritoneum – acts as the filter for cleaning the blood. Depending on the body’s type and size, the total surface area of the peritoneum is between one and two square meters. The peritoneum has characteristics similar to those of the dialyzer: pores in the membrane allow certain substances through while retaining others. Of the more than 2.5 million dialysis patients around the world, about 270,000 choose peritoneal dialysis treatment.


    A catheter – a small plastic tube – that was inserted during an operation is used to introduce dialysis solution into the abdominal cavity. The blood-rich peritoneum is surrounded by the fluid for several hours. During this period, metabolic toxins flow from the blood through pores in the peritoneum into the dialysis solution. At the same time, glucose in the dialysis solution pulls excess water out of the body. The solution containing the toxins and excess water is eventually removed through the catheter and replaced with fresh solution.


     

Dialysis products

Fresenius Medical Care offers a comprehensive range of products for hemo and peritoneal dialysis, covering all aspects of dialysis treatment.

About half of all dialysis machines and dialyzers sold each year are produced by Fresenius Medical Care.


  • Dialyzers

    In hemodialysis, the dialyzer acts as an artificial kidney and replaces vital functions of the natural organ. Blood flows through as many as 20,000 extremely fine fibers, known as capillaries, clustered in a plastic tube approximately 30 centimeters long. The capillaries are made of Fresenius Polysulfone, a special plastic with exceptional filtering and hemocompatibility characteristics. Pores in the capillaries filter metabolic toxins and excess water from the blood and flush them out of the body with dialysis fluid. Blood cells and vital proteins remain in the blood. Dialyzers are used only once in most industrialized countries.

    Almost half of all dialyzers in use worldwide come from Fresenius Medical Care's production sites.

     

  • Dialysis machines (Hemodialysis)

    The computer-controlled dialysis machine is one of the most important products in the treatment of chronic renal patients and, in hemodialysis, it takes over a number of key functions – it pumps blood from the patient’s body through the blood lines to the dialyzer (artificial kidney or filter). There, a fluid known as dialysate transports the toxins and excess water filtered from the blood away from the body. The fluid is introduced against the flow of blood through a separate circuit that is also controlled by the dialysis machine. In addition, the device injects drugs (such as Heparin) that restrain coagulation. The system has a number of automatic monitoring and control functions that ensure a safe and efficient dialysis treatment for patients.


    More than half of all dialysis machines worldwide come from Fresenius Medical Care's production sites.

     

  • Systems for peritoneal dialysis

    Two treatment options are available for peritoneal dialysis. In Continuous Ambulant Peritoneal Dialysis (CAPD), patients change the dialysis solution with the help of bag systems four to five times a day. In Automatic Peritoneal Dialysis (APD), a dialysis machine (cycler) takes over the exchange of fluid, making overnight treatment possible. Most patients carry out both types of treatment themselves, either at home or in the office. This allows them to be flexible and to maintain their normal rhythm and job.

  • Supplemental drugs

    Dialysis may perform most of the kidneys’ vital functions but it can not entirely replace the natural organ. For this reason, patients with chronic kidney failure must also take drugs to control e.g. the balance of minerals in the body and prevent a lack of red blood cells (anemia). Fresenius Medical Care produces and markets selected medications for the treatment of chronic renal patients and will continue to expand its product portfolio.

Dialysis services

The wide majority of hemodialysis patients undergo out-patient treatment at one of about 28,000 dialysis centers around the world. The blood-filtering therapy is usually administered three times a week and lasts three to five hours per treatment. When patients are not receiving treatment, they lead largely normal lives.

Home dialysis is an alternative to treatment at a dialysis clinic. Although peritoneal dialysis is already an established form of home dialysis, home hemodialysis is comparatively rare. Working patients especially benefit from home dialysis since it offers more flexibility. Treatments can be scheduled to fit their professional and private lives. They no longer have to commute for treatments, winning valuable extra time.

  • Dialysis at a Clinic

    Fresenius Medical Care itself operates more than 3,400 dialysis centers around the world and bases its dialysis treatment on high quality standards. Experienced doctors and well-trained personnel care for the patients. The goal is to use innovative therapy concepts and modern technology from Fresenius Medical Care to ensure the best-possible quality of life for chronic kidney patients.

     

  • Dialysis at Home

    Because of the complicated procedure, home hemodialysis is only appropriate for a small number of usually younger patients. Older dialysis patients often suffer from additional illnesses that make it difficult to perform dialysis at home. In addition, patients must have enough room for the treatment and a dialysis assistant.