Glossary

A protein that has two important functions. On the one hand, it contributes by its relatively large amount to the fact that the liquid contained in the blood remains in the bloodstream and does not penetrate the arterial walls into the surrounding tissue. On the other hand, it is an important transport protein for various substances. Among others, many drugs, but also free fatty acids and hormones are bound to albumin and are transported in the blood throughout the body. The level of this protein provides information on the general nutri-tional condition of a patient.

Reduced oxygen transport capacity of the blood, measured as reduced hemoglobin content in the blood.

Agents (e.g. heparin) that prevent blood coagulation.

A direct surgically created connection between an artery (blood vessel carrying blood from the heart to the body) and a vein (blood vessel carrying blood to the heart) in the patient‘s forearm. This connection forms a large blood vessel with an increased blood flow, providing access for hemodialysis. Adequate vascular access is a prerequisite for hemodialysis.

Machine-supported version of peritoneal dialysis treatment usually performed at night.

Device that can be used to precisely measure the composition of the human body and its fluid status and hence to determine the level of overhydration in dialysis patients.

Dry bicarbonate concentrate for online production of liquid bicarbonate concentrate used in bicarbonate hemodialysis with our hemodialysis machines of the 4008 and 5008 series ONLINEplus system.

Environmentally friendly material for producing foils, tubing and other components for peritoneal and acute dialysis. Biofine^® is recyclable and PVC-free.

Fluid circulating in the body consisting of plasma and cells (red blood cells, white blood cells, platelets, etc.). The main function of blood is to transport oxygen, nutrients and hormones to the cells and to remove waste products (such as carbon dioxide and urea). Blood also regulates the water and electrolyte balance and helps fight off contaminantsas part of the immune system.

Blood cells responsible for transporting oxygen. They are produced by erythropoietin, a hormone formed in the kidneys.

Blood cells that defend the human body against infection. They are involved in allergic reactions and destroy damaged, old or dead cells in the body.

A complex process during which blood forms solid clots. It is an important part of hemostasis whereby a damaged blood vessel wall is covered by a fibrin clot that stops hemorrhaging and helps repair the damaged vessel. Disorders in coagulation can lead to increased hemorrhaging and/or thrombosis and embolism. During dialysis treatment, blood coagulation is inhibited with anticoagulants such as heparin.

Tubing system connecting a patient‘s blood circulation with a dialyzer during the dialysis treatment.

An extension of the therapy options to more effectively influence the bone and mineral metabolism in patients with chronic kidney disease. Calcimimetics are administered when the thyroid gland is hyperactive, as is often the case with dialysis patients. Calcimimetics also have a positive effect on the calcium level of the bones.

A flexible tube inserted by surgery through the skin into a blood vessel or cavity to transport fluid into or out of the body. In peritoneal dialysis, a catheter is used to infuse dialysis solution into the abdominal cavity and drain it out again. In hemodialysis, a catheter can be used as a vascular access for dialysis treatment. In this case, the catheter is usually inserted into the superior vena cava, or occasionally the femoral vein.

A treatment method where the dialysis solution is exchanged manually, generally four times a day.

An increased blood glucose (sugar) level resulting from the body‘s inability to use glucose efficiently. As the main regulatory hormone in sugar metabolism, insulin is normally used to control this condition.

Form of renal replacement therapy where a semipermeable membrane – in peritoneal dialysis the peritoneum of the patient, in hemodialysis the membrane of the dialyzer – is used to clean a patient‘s blood.

Fluid used in dialysis in order to remove the filtered substances and excess water from the blood.

Special filter used in hemodialysis for removing toxic substances, waste products of metabolic processes and excess water from the blood. The dialyzer is sometimes referred to as an “artificial kidney”.

Semi-permeable barrier in the dialyzer to separate the blood from the dialysis solution.

Erythropoiesis-stimulating agents (ESA)Recombinant human EPO that is commonly prescribed to patients on dialysis who suffer from anemia.

Hormone that stimulates the production of red blood cells.

European clinical database for ensuring the quality of dialysis treatment. The database records the treatment data of dialysis patients and allows an efficient comparison of treatment quality among individual dialysis clinics.

The GFR indicates the volume of liquid that the kidneys filter from the blood per minute (primary urine). This ranges from more than 90 ml/min in healthy kidneys (stage 1) to less than 15 ml/min (stage 5) when dialysis or a kidney transplant is needed. Persons with stage 4 chronic kidney disease (CKD) have advanced kidney damage (GFR of 15 to 29 ml/min); it is highly likely that these patients will need dialysis or a kidney transplant in the near future.

Stages of chronic kidney disease according to the U. S. National Kidney Foundation:

Hemodiafiltration is a process that combines hemodialysis and hemofiltration. The theoretical starting point for combining these two processes is the fact that low-molecular substances such as urea and creatinine are predominantly removed by diffusive transportation such as in hemodialysis, whereas the larger molecules are to be predominantly removed by convective transportation as in hemofiltration. In hemodiafiltration (HDF), the total amount of removed toxins is higher than in the individual processes, since convection and diffusion do not add up, but run in parallel and influence each other. The more permeable synthetic membranes (“high-flux dialyzers”) with superior ultrafiltration performance are used for hemodiafiltration. As in hemofiltration, the ultrafiltrate is replaced by a sterile solution (substitution solution) in hemodiafiltration.

Treatment method for dialysis patients where the patient’s blood flows outside the body through disposable bloodlines into a special filter, the dialyzer. The dialysis solution carries away waste products and excess water, and the purified blood is returned to the patient. The process is controlled by a hemodialysis machine that pumps blood, adds anti-coagulants, regulates the purification process, and controls the mixing of the dialysis solution and its flow rate through the system. A patient typically receives three treatments per week, lasting from three to six hours each.

A type of treatment for patients with chronic kidney failure that does not use dialysis solution. The solutes are removed by using convective forces to filter plasma water through a semi-permeable membrane. Substitution fluid is used to replace the volume removed by filtration.

Substance in red blood cells that carries oxygen throughout the body.

Universal anticoagulant substance that is administered during hemodialysis to inhibit the blood coagulation.

A therapy system of the hemodiafiltration (HDF). With HighVolumeHDF^® the substitution volume by convective transport is higher than with HDF. Recent studies proof that the HighVolumeHDF^® therapy significantly improves patient survival rates compared to conventional dialysis treatments.

Iron product for the treatment of anemia resulting from iron deficiency in dialysis patients. An example is the product Venofer.

The kidneys are located at the rear of the abdominal cavity, one each on the right and left side of the spinal column. These vital organs are approximately 10 to 12 cm long and weigh only around 160 grams each. The kidneys ensure a regulated acid-base balance by filtering excreta and producing urine. Approximately 1,700 liters of blood normally pass through an adult’s kidneys every 24 hours.

Acute loss of renal function. Depending on the severity of renal function loss, treatment may be necessary. In contrast to chronic kidney failure, dialysis can help completely restore kidney function in many patients.

Permanent failure of the kidney (terminal kidney failure) resulting from slow and progressive final loss of kidney function (no longer detoxification of the body) over several years. Since the renal function cannot be recovered, the patient has to be treated with renal replacement therapy, i. e. kidney transplantation or dialysis. Chronic kidney failure is accompanied by long-term complications such as renal anemia, hypertension and other cardiovascular problems, as well as bone disease, loss of appetite and malnutrition.

A surgical procedure to implant a kidney from a donor.

Indicator to evaluate treatment quality. It is calculated by dividing the product of urea clearance (K) and the duration of treatment (dialysis time, t) by the filtration rate of certain toxins (the urea distribution volume in the patient, V).

Innovative device with PIN technology (automatic inline-closing system to eliminate the risk of contamination during disconnection from peritoneal dialysis systems) for automated peritoneal dialysis marketed exclusively in the U. S. The Liberty Cycler automatically regulates the exchange of used and fresh dialysis solution. It is equipped with a state-of-the-art pumping mechanism, is easy to set-up and also has integrated patient data management software.

A system for our 4008 and 5008 series hemodialysis machines to perform online hemodiafiltration and online hemofiltration. Online means that the dialysis machine automatically produces the infusion solution for treatment. The online method is a safe, user-friendly, resource-saving and cost-efficient alternative to ready-made infusion solutions in bags.

Dialysis treatment method using the patient‘s peritoneum, i. e. the tissue that covers the inner surface of the abdominal cavity and the abdominal organs, as the dialyzing membrane for blood purification. A sterile dialysis solution is introduced and removed through a catheter that has been surgically implanted into the patient’s abdominal cavity. The solution absorbs toxins and excess water. Most treatments are supported by a machine, the cycler, and are administered by the patients at home or at work several times a day or during the night.

Phosphate binders bind excess phosphate obtained via food within the intestine. Excess phosphate is normally discharged by healthy kidneys. This filtering process can only partially be replaced in patients with chronic kidney failure by dialysis. Too much phosphate in the blood can cause numerous adverse effects, such as bone disease, thyroid problems and vascular calcification. PhosLo, OsvaRen or Velphoro (PA21) are examples of phosphate binders for patients with chronic kidney disease.

A polymer (plastic) used to produce dialyzer membranes. It is characterized by extreme thermal stability, chemical resistance and blood compatibility.

Number of patients who suffer from a specific disease within a defined period.

Automated peritoneal dialysis system offering the full range of peritoneal dialysis options as well as a maximum of safety and comfort for the patient, physician and nursing staff. Compared to previous models, sleep•safe harmony, launched in the year under review, is even easier to operate and offers tailor-made solutions to meet patient’s requirements.