Dialysis
Dialysis is a medical treatment that performs some of the vital functions of healthy kidneys. It is used when the kidneys are no longer able to effectively remove waste products and excess fluids from the body over an extended period. Typically, dialysis becomes necessary when kidney function declines to about 10–15% of normal capacity, a condition known as End-Stage Renal Disease (ESRD).
Dialysis helps maintain the body’s internal balance by removing waste, excess salt, and water to prevent their accumulation. It also stabilizes the levels of certain essential chemicals in the blood, such as potassium, sodium, and bicarbonate, and assists in regulating blood pressure.
While dialysis can replicate some of the functions of healthy kidneys, it does not cure kidney disease. Patients with chronic kidney failure generally require lifelong dialysis unless they undergo a successful kidney transplant.
Hemodialysis Machine
A hemodialysis machine is a medical device used to remove toxic substances such as urea and ammonia from the blood through a dialysis filter. It serves as a substitute for kidney function in cases of renal failure or complete kidney shutdown.
Fresenius hemodialysis machines enable dialysis procedures without the need for additional equipment. During operation, the machine displays the circulation of the dialysis solution and the extracorporeal blood flow. As the dialysis solution circulates within the device, purified water—processed through a Reverse Osmosis (RO) system—is mixed with dialysis concentrate, heated, degassed, and transferred to the dialysis filter. The inflow and outflow volumes are balanced accordingly.
The pressure within the dialysis filter is regulated based on the selected ultrafiltration rate (UF Rate) and the specifications of the filter in use. In the extracorporeal blood circuit, heparin is continuously injected into the blood via a heparin pump, and the blood is directed into the dialysis filter by a blood pump.
The dialysis filter is a tubular chamber containing semi-permeable membranes. Blood is pushed into the filter while the dialysis fluid flows around the membrane within the chamber. The dialysis fluid typically contains sodium, potassium ions, and glucose. Toxic substances in the blood pass through the semi-permeable membrane into the exchange chamber of the filter and are removed by the machine. The cleansed blood is then returned to the patient’s body.
An air detector prevents the entry of air into the bloodstream. Dangerous blood leakage is prevented by a blood leak detector, a blood discharge monitor, and a module that displays venous return pressure.
The hemodialysis machine can operate with either acetate or bicarbonate solutions. The mixing ratio of concentrates with purified water is programmable (default setting: 1:34), and other ratios can be adjusted as needed. Depending on the concentration used, sodium levels can be re-adjusted within a range of 125–150 mmol/L, and bicarbonate levels can be set within a range of ±8 mmol/L.
Bicarbonate is supplied in powder form (sodium bicarbonate powder, NaHCO₃), which is converted by the machine into a ready-to-use solution. The option to use bicarbonate powder is available via a dedicated module installed on the dialysis machine.
The machine also allows for ultrafiltration without dialysis fluid circulation, known as dry dialysis or ISO-UF. The dialysis fluid flow rate can be set to 300, 500, or 800 ml/min.
Selectable programs are available for cleaning and disinfection of the machine. The hemodialysis system is equipped with a safety system essential for proper device operation and patient safety, in compliance with EN60601-1 standards.
Before each use, the safety system performs an automatic T1 test, which must be activated by the user. In the following cases, the machine will prompt the user to initiate the T1 test, or perform it automatically:
- After powering on the device using an external power source
- After completing a cleaning cycle
As an additional safety feature, the machine performs a circulatory pressure holding test, which detects any leakage within the closed system.
Technodialysis Unit
The Technodialysis Unit is responsible for after-sales services for Fresenius hemodialysis machines manufactured in Germany. The unit consists of two main divisions: Central Repair Workshop and Field Support & Supervision.
- Central Repair Workshop
This division is tasked with repairing dialysis machines and their related components. Its technical experts utilize advanced laboratory-grade diagnostic tools to service the electronic and hydraulic systems of the equipment.
- Field Support & Supervision
This division, staffed by specialized technicians, is responsible for routine servicing and on-site repairs at medical centers. It also conducts direct and structured oversight of technician performance to ensure continuous improvement in service delivery.
One of the key initiatives of the Technodialysis Unit has been the regional zoning of service coverage and the establishment of offices in several provinces—including Tehran, Mashhad, Karaj, Shiraz, Isfahan, Kermanshah, Gilan, Semnan, and Tabriz. This has significantly enhanced service quality and reduced response times to under 24 hours in provincial capitals and under 48 hours in affiliated cities.
In recent years, the growing number of dialysis patients in the country, combined with the critical safety requirements of dialysis machines and water purification systems—due to their direct interaction with patients’ blood—has made timely servicing, repair, and calibration by authorized representatives vitally important. The increasing demand for dialysis machines and the need for reliable operation underscore the necessity of an active and responsive service infrastructure.
Given the diversity of dialysis machines in use nationwide, approximately 70% are Fresenius models, initially including models 1008 and 2008, and currently models 4008 and 4008 Classic. Helal Iran Medical Equipment Company, affiliated with the Iranian Red Crescent Society, holds the official sales and after-sales service representation for these devices.
The Technodialysis Unit, through its dual structure of central repair and field support, and its strategic regional deployment, has significantly improved service quality and reduced response times to less than 24 hours in service hubs and less than 48 hours in surrounding areas.