Review of Hemodialysis for Nurses and Dialysis Personnel, 8th Edition

Glossary

AAMI (Association for the Advancement of Medical Instrumentation) This organization set the standards and recommended practices for dialysis machines, reuse of dialyzers, electrical safety, monitoring and culturing of machines and water systems, cleaning of machines, quality of water used for dialysis, and methodology for bacteriology and culturing samples.

ABO typing A blood test used to determine red blood cell type.

activated clotting time (ACT) A test to measure the clotting time of the blood.

acute Adjective used in two ways: to indicate that something is of short duration or sudden onset and to indicate a high degree of severity.

acute tubular necrosis (ATN) A kidney disorder involving damage to the tubule cells of the kidneys, resulting in acute kidney failure. In renal transplant, it refers to reversible kidney damage resulting in delayed kidney function.

adsorb To cause particles or molecules in solution to stick to the surface of a solid material.

air embolus Air bubble carried by the bloodstream to a vessel small enough to be blocked by the bubble.

albumin A protein found in many body tissues. It disperses in water as a colloid and is an important fraction of blood plasma. Molecular weight is approximately 68,000 Da.

allograft A graft, such as a kidney, taken from another person (Greek allo, “other”). The donor may be a blood relative or unrelated.

amino acids Building blocks of protein. Amino indicates that one or more hydrogen ions of an acid have been replaced by the radical (NH2). Amino acids also contain carbon, oxygen, and frequently sulfur.

amyloid Abnormal protein material occurring in certain disorders as deposits in various body tissues. In chronic kidney disease patients, it results from longtime accumulation of β2-microglobulin.

analog A structure whose function is similar to that of another organ or structure of a different kind and origin.

anaphylaxis A particularly severe type of systemic reaction to a foreign protein or other substance. It results from previous sensitization to the particular substance and can be fatal.

aneroid Pressure gauge (positive or negative) that contains no fluid.

aneurysm A blood-filled sac formed by stretching and dilation of the wall of an artery.

angiogram X-ray film of a blood vessel obtained by injecting a liquid contrast material into the vessel.

anion Ion carrying a negative (–) electric charge. It is unlike electric charges that attract one another, hence the negatively charged particle is attracted to the positive pole (the anode).

anterior In front or toward the front position.

antibody A protein substance made by the body’s immune system in response to a foreign substance.

anticoagulant Medication or chemical to prevent clotting.

antigen A molecule capable of combining specifically with antibody, resulting in either an immune response or a specific tolerant state.

antiseptic Chemical that stops the growth and reproduction of bacteria or germs; it does not necessarily destroy them.

anuria Complete cessation of urine flow.

APTT/PTT Activated partial thromboplastin time.

ARF Acute renal failure.

arrhythmia Any variation from the normal rhythmic heartbeat.

arterial Anything that has to do with an artery or arteries.

arteriovenous Involving both artery and vein.

artery Blood vessel carrying blood under pressure from the heart to the various parts of the body.

ascitic fluid (ascites) An accumulation of fluid in the abdominal cavity. Usually contains protein to a varying degree.

aseptic Free of bacterial or infectious organisms; sterile.

aspirate Remove something by suction or negative pressure.

atherosclerosis A type of arteriosclerosis (hardening of the arteries) caused by degeneration and fatty changes in the walls of the arteries.

atony Lack of normal tone or strength.

autoclave Device for sterilization of materials, using saturated steam under pressure.

autogenous Produced within the organism itself.

azotemia Retention of nitrogenous wastes (urea, creatinine) in blood and body fluid.

bacteremia Presence of bacteria in the bloodstream.

bacteria Small one-celled plantlike organisms; widely prevalent everywhere. Many kinds are harmless or beneficial; certain ones cause infections and may be dangerous.

bioavailability The amount of an administered drug absorbed into the bloodstream that actually reaches the intended site of action in the body.

biocompatible Not causing change or reaction in living tissue. A biocompatible membrane would not damage blood cells, cause clotting, or release pyrogenic matter.

blood cells Cellular elements of blood. Red blood cells are vital for transport of oxygen from lungs to tissues; white blood cells act to combat infection and destroy bacteria.

β2M/β2-microglobulins A protein found on the surface of many cells.

bradycardia Slow pulse rate or heart rate.

bruit An abnormal sound or murmur heard by listening over a blood vessel with a stethoscope; expected sound heard over a vascular access of a dialysis patient produced by the blood flowing through it.

BUN (blood urea nitrogen) A chemical determination of the amount of nitrogen, derived from urea, present in the blood. Actual urea is 2.2 times the BUN value. Normal BUN is 9 to 15 mg/dL (3 to 6.5 mmol/L).

BUN-creatinine ratio Normal ratio is 10:1.

cachexia General ill health and malnutrition. Wasting.

cadaver donor A person who has died and whose family has agreed to donate the organs for transplantation.

calcium-phosphorus product Calcium (in mg/dL) multiplied by phosphorus; product should be less than 70.

calibrate Adjust or accurately set a measuring device by comparison with a known standard.

cannula Tube that is inserted into a body opening.

CAPD Continuous ambulatory peritoneal dialysis.

carbohydrate One of the three main categories of basic foodstuffs; composed of carbon, hydrogen, and oxygen and readily used by the body for energy. Starches and sugars are carbohydrates.

cardiomyopathy Any weakness or dysfunction of the heart muscle. Usually there is dilation and enlargement of the heart.

catabolism Breakdown of body tissue at a rate faster than its restoration.

catheter A hollow tube for withdrawing or introducing fluid into a cavity or passage of the body.

cation Ion carrying a positive (+) charge that is attracted to the oppositely charged electric pole, the cathode.

caudad Toward the tail or the tailbone.

CAVH (continuous arteriovenous hemofiltration) A treatment used in the management of acute renal failure in hemodynamically unstable patients. This slow continuous form of ultrafiltration does not involve the use of a blood pump, but uses the patient’s mean arterial pressure to circulate the blood through the extracorporeal circuit.

CAVHD (continuous arteriovenous hemodialysis) A treatment used in the management of acute renal failure in critically ill patients. Does not involve the use of a blood pump, but uses the patient’s arterial blood pressure to circulate blood through the extracorporeal circuit.

CCHT Certified clinical hemodialysis technician.

CCNT Certified clinical nephrology technologist.

CCPD (continuous cycling peritoneal dialysis) A type of dialysis in which the patient is attached to a peritoneal dialysis automatic cycler for short exchanges throughout the night. During waking hours, the patient receives a long dialysis exchange but without the use of the machine.

CDC (Centers for Disease Control and Prevention) The CDC is one of the major operating components of the Department of Health and Human Services. It functions to protect health—through health promotion; prevention of disease, injury and disability; and preparedness for new health threats.

Cellulose A complex carbohydrate polymer of form (C6H10O5)N. It is the fibrous support structure of plants. Treatment with heat and chemicals produces a semipermeable membrane.

Cephalad Toward the head.

CHF (congestive heart failure) Also HF for heart failure. A condition in which the heart pumps less effectively due to excess body fluid.

Chloramine Chemical compound containing chlorine attached to nitrogen, forming NCl groups.

CHT Certified hemodialysis technician.

CKD Chronic kidney disease.

clearance Mathematic expression of the rate at which a given substance is removed from a solution; for example, the clearance of urea from blood by the natural or an artificial kidney. It is defined as the number of milliliters of solution that would be completely cleared of a given solute in one minute.

CLIA Clinical Laboratory Improvement Act.

CNN Certified nephrology nurse.

coagulation Formation of a blood clot.

colloid A very finely divided substance, larger than a molecule, that spreads throughout a liquid as tiny particles. A colloid does not actually dissolve in the liquid or cross a semipermeable membrane. It does exert an osmotic effect proportionate to its concentration. Serum albumin is a colloid.

comorbid A coexisting illness or disease process not directly related to the primary disorder. It may make the overall course more complicated or adversely affect the outcome.

compliance Capacity to yield or stretch. Also the adherence to a plan of care such as dietary and fluid restrictions.

compound A distinctive substance formed by the chemical union of two or more elements in definite proportion by weight.

concurrent As applied to a dialyzer, dialysis fluid and blood flow are in the same direction.

conductivity Ease with which an electric current is carried or conducted through something. The conductivity of dialysate solution is proportional to its electrolyte content.

congestive heart failure (CHF) A condition in which the heart pumps less effectively due to excess body fluid.

contaminate Make dirty, impure, or unsterile.

convection Movement of solute across a membrane caused by bulk flow of solution.

countercurrent In a dialyzer the direction of flow of dialysis fluid and of blood are 180 degrees opposite one another.

CQI Continuous quality improvement.

creatinine One of the nitrogenous waste products of normal muscle metabolism. It is produced at a fairly constant rate in the body.

creatinine clearance A test that measures how efficiently the kidneys remove creatinine from the blood.

Crit-Line monitor An arterial in-line medical instrument that provides continuous measurement of absolute hematocrit, percent blood volume change, and oxygen saturation in real time. It measures blood volume change based on the hematocrit because these two values have an inverse relationship. As fluid is removed from the intravascular space, the blood density increases. This is displayed in percent of blood volume change on a gridlike graph on the instrument’s screen. With this device, it is possible to maximize ultrafiltration safely and prevent hypotension, cramping, and other intradialytic complications associated with volume depletion. A disposable blood chamber is attached to the arterial side of the dialyzer and a photometric technology is used. This device also measures access recirculation.

CRF Chronic renal failure.

crossmatching The testing of blood and tissues to check for the compatibility of a donor organ with a recipient. A positive crossmatch indicates that the donor and recipient are incompatible.

CTS Carpal tunnel syndrome.

CVVH (continuous venovenous hemofiltration) A slow system of removing fluid from a patient over a long period of time through a venous access.

CVVHD (continuous venovenous hemodialysis) A slow process of removing fluid and electrolytes from a patient over an extended period of time through a venous access.

cyclosporine A An immunosuppressive medication, technically an undecapeptide. It is highly effective in controlling transplant rejection. However, it adversely affects kidney function.

cytomegalovirus (CMV) A group of species-specific herpetoviruses that infect humans and other animals. Often asymptomatic, but tends to exacerbate in immunosuppressed individuals, causing illness with cellular enlargement, cytoplasmic inclusions, and damage to various organs.

dalton (Da) One atomic mass unit. Named for John Dalton, a developer of the atomic concept.

debris An accumulation of fragments of miscellaneous material; rubbish or junk material.

degassing Process of importance in proportioning-delivery systems; removing the gases (largely air) normally dissolved in tap water.

deionize Remove the various solute ions from a solution. Usually it refers to a water treatment process that removes all electrolytes from the water.

Delta The Greek letter D (Δ) used in mathematics to indicate a differential or change between two points.

dementia Progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging.

dextran A glucose polymer.

dextrose A simple sugar, readily used by body cells for metabolism.

dialysance A term for the capability of a dialyzer to clear a given solute. It represents the net rate of exchange of a substance between blood and bath per minute per unit of blood-bath concentration gradient.

dialysate A chemical bath used in dialysis to draw fluids and toxins out of the bloodstream and supply electrolytes and other chemicals to the bloodstream.

dialysate flow rate Rate at which dialysate flows through the dialyzer

dialysis-quality water Water that by LAL testing is less than 1 EU/mL (negative) for mycobacteria and that meets AAMI chemical analysis standards for water used for dialysis.

diastole Period of relaxation of the heart; its filling phase.

diffusate Dialyzing fluid that has been used; it contains solutes not originally present. Often applied loosely to any dialyzing fluid.

diffusion Spreading out or scattering of different kinds of particles among each other.

dilate Expand or make wider.

dilute Thin out or weaken. A solution is diluted (made less concentrated) by the addition of more solvent. Chemical that destroys bacterial organisms.

distal In a direction away from the center of the body or from the point of attachment.

diuresis Increased output of urine.

diverticulum A pocket or pouch off the side of a tube or hollow vessel.

dry weight The weight of a dialysis patient when the blood pressure is normal and all excess fluid has been removed.

dwell time Length of time the dialysis solution stays in the peritoneal cavity during peritoneal dialysis.

dyspnea Shortness of breath.

dyspraxia Partial loss of ability to perform coordinated movements.

ecchymosis An extravasation or oozing of blood into the skin, as with a bruise.

edema Collection of fluid in body tissue; swelling, often soft and compressible.

effluent The outflow from something (usually liquid).

electrolyte Substance that separates into ions after going into solution.

embolus Clot, or portion of a clot, carried by the blood flow from a distant vessel and forced into a small vessel and blocking it.

encephalopathy Any gross dysfunction of the brain, temporary or permanent, that may result from anatomic damage, metabolic imbalance, or toxic agents.

endocarditis Inflammation of the endocardium, or interior lining of the heart. A serious condition that can be fatal.

endogenous Originating within the body. Metabolism of the nitrogenous constituents of cells and tissues.

endotoxin A toxic substance produced and held with the cells of bacteria until they die or are destroyed, whereupon it may be released.

EPO (epoetin alfa) Medication used to treat anemia.

equilibrium State of balance between opposing forces.

erythrocyte Red blood cell.

erythropoiesis Process of making red blood cells by the bone marrow.

erythropoietin A hormone, normally produced by the kidneys, that causes the bone marrow to produce red blood cells (erythrocytes). A synthetic form of the hormone, recombinant human erythropoietin, is used to treat anemia.

ESRD End-stage renal disease.

ethylene oxide A gas that may be used for sterilization of objects that might be damaged by heat. Articles must be dry and must be “aired” after sterilization.

euglycemia Normal blood glucose value.

euvolemia Normal intravascular volume.

exchange The process of changing used dialysate for fresh solution in peritoneal dialysis.

exit site Where a peritoneal dialysis catheter exits the skin.

exogenous Originating outside the organism. Due to external causes.

extracorporeal Outside the body.

febrile Feeling feverish; having an elevated temperature.

fecal Relating to a bowel movement or excretion from the bowel.

fibrin Protein product formed during the clotting of blood, usually threadlike strands.

fibrinolysin A substance that lyses, or breaks up, fibrin.

fistula Unnatural opening or passage. As related to dialysis, a surgical opening between an artery and vein to fill the vein with arterialized blood for blood access.

flowmeter Device for indicating rate of flow of a liquid past a given point.

flux The rate of flow or change across or through a surface.

formalin Disinfectant consisting of 40% formaldehyde gas in water.

gamma irradiation Gamma rays are a form of high-frequency, high-energy radiation emitted from radioactive atomic nuclei. They are very penetrating for a short distance and kill all bacteria, spores, and viruses that they strike.

gastroparesis A disorder in which the stomach takes too long to empty its contents. It often occurs in people with type 1 or type 2 diabetes; also called delayed gastric emptying.

globulin A class of proteins found in serum and tissue and of much larger molecular size than albumin. Certain serum globulins are involved in the immune response of the body and are called immunoglobulins (IgA, IgG, IgM, and so on).

glomerular filtration rate (GFR) Rate at which a given compound passes through the glomerulus in a given time.

glucose Same as dextrose.

gradient Rate of increase or decrease between two variables.

half-life The time it takes for the amount of drug in the body to decrease by one half.

hematocrit The cellular proportion of blood expressed as a percentage when blood is separated into its liquid and cellular elements by spinning in a centrifuge.

hematoma Accumulation of blood that has escaped from a blood vessel into surrounding tissue.

hematuria The presence of red blood cells or blood in the urine.

hemofiltration Removal of water from the blood by ultrafiltration without dialysis. A volume of water with its solute load is removed by convective transfer. No osmolar gradient between body fluid compartments, which might cause symptoms, is generated.

hemoglobin Red protein portion of the red blood cells that has the capacity to bind oxygen temporarily while it is carried throughout the body.

hemolysis Breakup of red blood cells so that the hemoglobin is released into the surrounding fluid. Hemolysis may result from mechanical, chemical, or osmotic injury.

hemolytic-uremic syndrome An acute illness, most common in children and usually brought on by toxic bacterial diarrhea. Involves breakup of red cells (hemolysis) with release of hemoglobin, thrombocyte destruction, vascular endothelial injury, and acute kidney damage with azotemia and uremic symptoms and findings.

hemoperfusion Removal of noxious substances by passing blood over a column of charcoal or special resin that has high binding capacity. No dialysis or ultrafiltration is involved.

hemothorax A collection of blood in the space between the chest wall and the lung (the pleural cavity).

heparin Chemical that slows the natural clotting of blood.

hepatitis Inflammation of the liver, often caused by a viral infection but can result from toxic agents or medication.

HFAK Hollow-fiber artificial kidney.

Hg Mercury (Latin, hydrargyrum).

high-efficiency dialysis Nonconventional dialysis performed with a special dialyzer that uses a membrane of very large surface area, which allows middle molecular weight solutes (up to 5000 Da) to be diffused across the membrane in significant amounts.

high-flux dialysis Nonconventional dialysis performed with a special dialyzer that uses a highly permeable synthetic membrane that allows low and high molecular weight solutes (up to 12,000 Da) to be convected across the membrane.

human leukocyte antigen (HLA) Molecule found on cells in the body that characterizes each person as unique. Determines whether a recipient will accept a donor organ.

hydrolysate A substance produced from the breakdown of another substance by the addition of the elements of water.

hydrophilic Water loving; a substance that blends or combines well with water.

hyper- Prefix to indicate higher than or greater than some standard.

hyperglycemia A blood sugar level higher than normal.

hypertension Blood pressure that is higher than normal.

hypertrophy Abnormal enlargement of a body part or organ.

hypo- Prefix to indicate lower or less than the normal.

hypobaric Less than normal atmospheric pressure.

hypocalcemia Serum calcium value less than normal (normal: 9 to 11 mg/dL).

hypokalemia Serum potassium (Latin, kalium) less than normal (normal: 3 to 5 mEq/L).

hyponatremia Serum sodium (Latin, natrium) less than normal (normal: 135 to 145 mEq/L).

hypotension Blood pressure that is abnormally low.

hypovolemia Low volume within the vascular system.

iatrogenic A condition resulting from therapy or medical treatment.

icterus Jaundice.

idiogenic Something separate or independent, originating with an organ or cells.

IDPN Intradialytic parenteral nutrition.

immunosuppressant A drug used to suppress the natural responses of the body’s immune system; in transplant patients prevents organ rejection.

in vitro A test done not in a living organism but in a synthetic environment for the particular test.

in vivo A test done in a patient or in a living experimental animal.

infarction An area of tissue destruction resulting from obstruction of the local circulation usually from embolism or thrombosis.

infuse Introduce a fluid into something.

intima (tunica intima) The inner lining of blood vessels.

intravenous Within a vein (abbreviated IV).

ion Atom, or group of atoms, that has an electric charge.

IPD Intermittent peritoneal dialysis.

ischemia A temporary deficiency of blood supply.

isotonic Having the same concentration or the same osmotic pressure (Greek iso, “same” or “equal”).

jaundice Deposition of bile pigments in the skin, producing a yellowish tinge, caused by liver disorder or disease.

K Potassium (Latin, kalium).

KDOQI National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative.

kilogram 1000 grams; 1 kilogram equals 2.2 pounds.

kinetic Having to do with motion or movement.

kinetic modeling Sometimes called urea kinetic modeling (UKM). A mathematic tool used to prescribe and monitor dialysis therapy and to assess protein intake.

Kt/V A calculation result derived from urea kinetic modeling and identified adequacy of the dialysis treatment.

kUF The ultrafiltration coefficient, which ranges from 0.5 to 80 mL/h/mm Hg, depending on the membrane.

labile Unstable or easily changeable.

LAL Limulus amebocyte lysate. An assay for endotoxin that uses a protein extract from the horseshoe crab (Limulus). Values are given in nanograms (ng) or in endotoxin units (EU) (1 ng/mL = 5 EU/mL).

lateral To one side or the other.

lesion Any injury or wound or local area of degeneration.

leukocyte A white blood cell.

lipid A group of substances including fats and esters, a fatty or organic oily substance.

lot In manufacturing terminology, a group of units manufactured at the same time, from the exact same material, or to the same specifications.

lumen The open space within a tube or container.

lyse To destroy or break up cells.

macerate To soften or break up by immersion in water.

malrotate To rotate or turn incorrectly or inappropriately.

manometer Instrument or gauge to indicate pressure.

medial Toward the middle or midline.

metabolic acidosis Decreased pH and bicarbonate concentration in the body caused by the accumulation of acids.

metabolism Chemical and physical processes by which living organisms produce and maintain their own substance and develop energy for their use.

metastatic Disease or disorder that is transferred from one organ or tissue to another area not directly related to the primary site.

methemoglobin Hemoglobin in which the iron is in the ferric form rather than the ferrous form of normal hemoglobin. In this ferric form it cannot combine with oxygen to transport it in the normal way.

microalbuminuria Screening tests for the presence of albumin, or other protein in the urine, such as the widely used “dipstick,” generally do not detect protein in amounts less than 200 mg/dL. Sensitive analytic testing methodology measures much smaller or “micro” amounts.

microglobulin β2-microglobulin is a protein (molecular weight 11,800 Da) produced by normal turnover of nucleated cells in the body. It is catabolized by normal kidney tubules. In CKD, β2-microglobulin accumulates, leading to deposits of an abnormal protein—amyloid—in bone, joints, tendons, and elsewhere.

modeling Mathematic simulation using probability analysis to predict outcome from changes in the known variables of a particular process. Usually done by computer.

module Self-contained unit that may be combined with others of the same type to form a larger unit.

mole One molecular weight of any given substance expressed in grams.

molal Solution containing 1 mole of solute in 1 kg of solvent.

monitor To supervise or check on something; a mechanical or electronic device that checks or supervises some operation.

mono- Prefix indicating one.

mycotic A disease or disorder caused by a fungus rather than by bacteria.

necrosis Death of tissue.

nephrectomy Surgical removal of a kidney.

nephrologist Physician who specializes in kidney diseases and their treatment.

nephron Basic functioning unit of the normal kidney.

nephropathy Abnormal functioning of kidney. It may result from trauma, inflammation, toxic agents, or metabolic disorder.

neuropathy Damage to or disease of nerves.

NIPD Nocturnal intermittent peritoneal dialysis.

obtund Dull, stupid; poorly responsive.

obturator Metal rod or stylus that fits inside the tube of a trocar. It carries a sharp point and can be withdrawn from the trocar after insertion.

occlude Close off or shut off.

oliguria Daily urine output less than 400 mL, which is the minimum amount of normal urine that can carry away the daily load of metabolic waste products.

omentum Fold of peritoneum that hangs like an apron between the stomach and the anterior abdominal wall.

oncotic Osmotic pressure resulting from the presence of nonionic solutes and suspended materials such as plasma proteins.

OSHA Occupational Safety and Health Administration; a federal agency that edicts safety and health issues.

osmolality Osmotic effect of a solute based on the molal concentration of the solution.

osmometer Instrument for determining the osmolality of a solution. It operates by determining the precise depression of the freezing point of a solution, which is directly related to the concentration of particles of solute per unit amount of solvent.

osmosis Passage of solvent through a semipermeable membrane that separates solutions of differing concentrations.

osteitis fibrosa cystica Bone rarefaction with fibrous degeneration and cyst formation; a result of parathyroid overactivity.

osteoblast A cell that lays down new bone structure.

osteoclast A cell that resolves and removes bone structure.

osteodystrophy General term for defective bone formation; it includes osteomalacia, osteoporosis, and so forth.

osteomalacia Softening of bone caused by lack of calcium deposition.

osteoporosis Bone rarefaction or thinning caused by inadequate new bone formation.

palpitation Irregular jumping or pounding of the heart.

PAN A dialyzer made of polyacrilonitrile (synthetic) membrane.

parameter Quantity to which arbitrary values may be assigned, as distinguished from a mathematic variable, which can assume only values determined by the form of the mathematic function. Parameters measured in dialysis work are blood pressure, flow rates, conductivity, temperature, and so on.

panel reactive antibody (PRA) The percentage of cells from a panel of donors with which a potential recipient’s blood serum reacts. A higher PRA indicates that more antibodies are being made.

parathyroid glands Four small glands located on the posterior surface of the thyroid gland (para, “beside,” “adjacent to”). The parathyroid hormone is concerned with regulation of calcium in body fluid.

patent Open.

pathogenic Causing a disease or abnormal process.

peptide A compound of two or more amino acids in which the carboxyl group of one is linked to the amino group of the other. A polypeptide is a chain of such peptides connected in special sequence.

percutaneous Through the skin.

pericarditis Inflammation of the pericardium, the sac surrounding the heart.

peritoneal cavity Space surrounding the abdominal organs located under the abdominal muscles.

peritoneal equilibration testing (PET) Measures the characteristic of the peritoneum in terms of solute transport and ultrafiltration.

peritoneum The smooth, serous (and permeable) membrane that lines the abdominal cavity and covers the loops of intestine, the liver, and other organs.

petechia A small spot or freckle formed by blood leaking into skin; usually occurs in crops (petechiae).

phlebitis Inflammation involving the walls of a vein.

phlebotomy Release of blood from a vein.

photocell Electronic device sensitive to light. An electronic circuit may be closed or opened by its response to light.

physiology Life processes and functioning of living organisms.

plasma Fluid portion of blood (without cellular elements) before clotting occurs.

plasmapheresis Pheresis denotes “taking something away,” derived from Greek. Special filter units, usually hollow fibers, permit removal from serum of elements such as antibodies and immunoglobulins.

platelet A small circulating white blood cell, about 25% as large as a red blood cell, primarily concerned with instituting clot formation on contact with any abnormal surface of the circulatory system or a defect in the integrity of the system.

PMMA A dialyzer made of polymethyl methacrylate (synthetic) membrane.

pneumothorax The presence of air in the chest cavity between the wall of the cavity and the lung. Large volumes can constrict the movement of the lungs and lead to respiratory failure.

polymer A compound of the same elements in the same proportion as another but of differing molecular weight: CNOH, C2N2O2H2, C3N3O3H3, and so on. Many plastics are polymers of simple compounds.

pore A very small opening or hole.

posterior Behind or toward the back of something.

premorbid Before an illness.

protamine Substance that neutralizes the anticoagulant action of heparin by combining with it.

protein An essential constituent of all living cells that is formed from complex combinations of amino acids.

proteinuria A condition in which the urine contains large amounts of protein.

protein catabolic rate (PCR) Refers to a given patient’s protein metabolism expressed in grams of protein per kilogram.

proteinaceous Proteinlike, or material derived from protein.

proximal Near to a point or near to the central area.

pruritus Intense itching.

pseudoaneurysm (false aneurysm) Sac or outpocketing on the wall of a vein.

pseudomonas Genus of bacteria found in soil, water, sewage, and air. They are often highly pathogenic and resistant to many antibiotics.

pulsatile Rhythmic throbbing; a rhythmic forward thrust.

pyrogen Any substance or agent that causes a fever.

Qb Indication of blood flow rate.

Qd Indication of dialyzing fluid flow rate.

qualitative Identifying a substance as to kind.

quantitative Identifying a substance by amount present.

radial Located on the side of the forearm near the radius, the forearm bone that ends at the wrist near the base of the thumb.

recombinant Something manufactured by inserting the deoxyribonucleic acid (DNA) of a chosen or desired gene into the DNA of a bacterium, which reproduces itself generating more of the desired gene.

red blood cells See blood cells.

renal Pertaining to the kidneys (Latin ren, “kidney”).

renin A hormone produced in the kidney with important effects on sodium and potassium balance and on blood pressure.

resin Substance capable of binding, chemically or physically, some other substance and rendering it inactive.

reticulocyte Immature red blood cell.

retrograde In a backward manner, or opposite to the usual direction.

reverse filtration During high-flux dialysis a gradient from dialysate to blood may occur, a reversal of the usual blood-to-dialysate gradient. This reversal of flow may carry bacterial or pyogenic material into blood.

reverse osmosis (RO) The process of removing almost all solute from a solution by applying high pressure on it against a membrane permeable only to the solvent; used to purify water.

rhabdomyolysis Breakdown of muscle tissue with release of myoglobin into the circulation that may result from trauma or toxic substances. Myoglobin is toxic to the kidney and a cause of acute renal failure.

sclerosis An unusual hardening.

semipermeable membrane (SPM) A selective membrane allowing some substances to pass through while not allowing others.

septicemia Bacteremia with growth and multiplication of organisms in the blood. It is usually severe and may be life threatening.

serum Fluid portion of blood remaining after a clot has formed.

shunt Short circuit or bypass; in dialysis usage, the system of tubing that connects the flow of blood from the arterial cannula to the venous cannula when they are not needed for actual dialysis.

SI units An extension of the metric system used by clinical laboratories. The amount of substance is reported as moles/L rather than g/L or mg/dL.

sodium modeling/variation Technique of raising the sodium concentration in the dialysis bath for part of the treatment to minimize hypotension during fluid removal.

solute A dissolved substance.

solvent A liquid capable of dissolving a substance.

sorbent An agent that acts by its adsorption effect.

sphygmomanometer Device for measuring the blood pressure by means of an inflatable cuff placed around an extremity.

spores Certain bacteria, in an inactive or resting stage, that are highly resistant to antiseptic effect.

Staphylococcus Genus of bacteria, some of which normally inhabit skin or other body surfaces. Some are pathogenic and may cause serious infection.

sterile Completely free of any living microorganisms.

subcutaneous Underneath the skin.

sump Depression, or low point, for collecting fluid.

syndrome A complex or set of symptoms occurring together.

synthetic Made by humans; artificial; not occurring naturally.

systemic Affecting the entire body as a whole.

systole Contraction of the heart; its emptying phase.

tachycardia Excessively rapid heartbeat.

tamponade Compression or pressure on. Pericardial tamponade compresses the heart by pressure of fluid in the pericardial sac.

thermistor Small sensitive metal device that changes its electrical characteristics with temperature change. These changes are sensed by electronic circuitry and displayed on an indicator or recorder.

thermocouple Measuring device using a pair of coupled dissimilar metal conductors that bend when a temperature difference exists.

thrombosis Clot formation.

thrombus Clot formed in a blood vessel or a blood passage.

tight heparinization Monitoring activated clotting time to maintain a clotting of 90 to 120 seconds. This is used in managing the patient at risk for bleeding during the hemodialysis treatment.

tissue typing The matching of blood cells of transplant candidates with donors.

tortuous Full of twists or turns; winding.

TPD Tidal peritoneal dialysis.

transducer Device that transmits power from one system to another. For example, a pressure transducer converts the pressure (power) at its sensing surface to an electronic force that can be shown on an indicator or recorder.

trauma Injury or wound.

Trendelenburg position A body position in which the head is placed at a 45-degree incline downward on a table with the legs elevated.

trocar Tube with a sharp point for making puncture wounds.

turbulent Characterized by agitated or irregular mixing action.

ulnar Toward the ulna, the forearm bone on the inner side when the arm is held in the classic anatomic position.

ultrafiltration Filtration by a pressure gradient between two sides of a porous (filtering) material.

urea One of the chief nitrogenous waste products formed by metabolism or breakdown of protein in the body.

urea reduction ratio (URR) Another method to calculate adequacy of dialysis. The formula is percentage of urea reduction = 100 × (1 – Ct/Co).

uremia The symptoms manifested when there is a buildup of excess water and waste products in the body as a result of renal failure.

uric acid Breakdown product of certain proteins, known as nucleotides. Excessive amounts in blood may cause acute inflammation of joints known as gout.

urticaria An allergic skin reaction; hives.

vascular Having to do with the blood vessels.

veins Blood vessels that return blood from various parts of the body to the heart. Usually they are under lower pressure and have thinner walls than arteries.

venospasm Involuntary contraction or narrowing of a vein.

venous Anything related to the veins.

vestibular Having to do with the vestibule of the inner ear, which is concerned with maintaining balance.

virus Submicroscopic, infectious living agents that are causative factors of many illnesses. They are completely dependent on the cells of the host that they infect. They are not sensitive to antibacterial medications.

white blood cells See blood cells.

xenograft A graft of tissue or an organ taken from a different animal species.



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