Analyse van de bloedstollingsactivatie tijdens hemodialyse - in afwezigheid van macroscopische stolling van het hemodialysecircuit - en klinische validatie van een hemodialysetechniek zonder systemische anticoagulatie.

Haemodialysis (HD) is the most frequently used treatment modality for patients suffering from kidney failure. During HD, blood and dialysate are pumped through an extracorporeal circuit across respectively blood and dialysate sides of a dialyzer, built of a semi-permeable membrane. The flow of blood and dialysate across both sides of the dialyzer allows removal of excess blood toxins and water. The contact of blood with the extracorporeal circuit materials (blood lines, pumps, dialyzer) induces blood clotting, a process, the mechanisms of which are not well elucidated.
Blood thinners - medication to prevent blood clotting - are routinely administered during HD in order to prevent obstruction of the extracorporeal circuit. This treatment however induces a bleeding tendency within the patient and can lead to significant blood loss in patients at increased bleeding risk. The current available techniques for HD avoiding the use of blood thinners are compromised by an importantly increased workload and potentially life-threatening metabolic risks.
This PhD project aims to better understand the mechanisms of blood clotting during HD by the use of advanced biological assessments and specific and novel dialyzer membrane measurements. Secondly, retrospective and prospective clinical trials are set-up to validate the adequacy of a novel, simple and safe HD strategy combining a specific dialyzer and dialysate enabling HD without the use of blood thinners, in terms of dialysis adequacy.