Glossary

A protein with two important functions: On the one hand, it binds water and therefore ensures that the liquid contained in the blood remains in the bloodstream and does not pass through the arterial walls into the surrounding tissue; on the other, it transports various important substances, for example, numerous drugs as well as free fatty acids and hormones that are bound to albumin and transported throughout the body with the blood. The level of this protein provides information about a patient’s general nutritional condition.

Reduced ability of the bloodto transport oxygen, measured as a lower hemoglobinconcentration in the blood.

An agent (e.g. heparin) that prevents blood coagulation.

A direct, surgically created connection between an artery (blood vessel carrying bloodfrom 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.

The 5008 and 6008 series hemodialysis machines have an AutoFlow function. This automatically adapts the dialysate flow to the effective blood flow to ensure that water, energy and dialysate are used more efficiently. The devices also have an EcoFlow function, which minimizes the use of dialysate and energy in all phases other than actual treatment, for example during preparation when the dialyzeris rinsed with dialysate.

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 blood cells (red blood cells, white blood cells, platelets, etc.). The main function of blood is to transport oxygen, nutrients and hormones to the body’s cells and to remove waste products (such as carbon dioxide and urea). Blood also regulates the water and electrolyte balance and helps ward off contaminants as part of the immune system.

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

Blood cells responsible for defending the human body against infections. They are involved in allergic reactions and destroy damaged, old or dead cells in the body.

A complex process in which blood forms solid clots, stemming the flow of blood. The damaged wall of a blood vessel is covered by a fibrin clot that stops hemorrhaging and helps repair the vessel. Coagulation disorders can lead to increased hemorrhaging and/or thrombosis, and even embolism. During dialysis treatment, blood coagulation is inhibited with anticoagulants (such as heparin).

Tubing system connecting a patient’s blood circulation to a dialyzer during dialysis treatment.

Drugs that have a positive effect on the bone and mineral metabolism, which is often disturbed in kidney patients. Calcimimetics supplement treatment for patients with chronic kidney failure.

A flexible tube inserted surgically through the skin into a blood vessel or a cavity to transport fluid into or out of the body. In peritoneal dialysis, a catheter is used to infuse dialysate 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, it is usually inserted into the superior vena cava, or occasionally the femoral vein.

A treatment method in which the dialysateis exchanged manually, generally four times a day.

A law that became effective in April 2017 to change the German Commercial Code with the aim of strengthening non-financial reporting by certain major capital market companies in their (group) management reports.

A device that automatically exchanges the dialysis solution that flows through the peritoneum and removes excess water and harmful substances from the patient’s body over a period of several hours, typically at night.

The German stock index, calculated on the basis of the weighted prices of the 30 largest German stock corporations in terms of market capitalization and trading volume.

An increased blood sugar level resulting from the body’s inability to regulate glucose efficiently in the body’s cells. This condition can usually be controlled by injecting insulin, the main regulatory hormone in sugar metabolism.

A form of renal replacement therapy where a semi-permeable membrane – the patient’s peritoneum in peritoneal dialysis or the membrane of thedialyzer in hemodialysis– is used toclean a patient’s blood.

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

A special filter used in hemodialysis to remove toxic substances, waste products of metabolic processes and excess water from the blood. The dialyzer is frequently referred to as an “artificial kidney”.

A semi-permeable barrier in the dialyzer that separates the blood from the dialysate.

Recombinant (artificially produced) 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.

U.S. Food and Drug Administration.

Indicates the volume of liquid filtered by the àkidneys from the àblood per minute (primary urine). This canbe more than 90 ml/min in healthy kidneys (stage 1). If the GFR is lessthan 15 ml/min (stage 5), dialysis or a kidney transplant is needed. Patients with stage 4 chronic kidney disease (GFR of 15 to 29 ml/min) have advanced kidney damage; 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:

A process combining hemodialysisand hemofiltration. This is based on the theory that low-molecular substances such as urea and creatinine are predominantly removed by diffusive transportation as in hemodialysis, whereas the larger molecules are mainly removed by convective transportation as in hemofiltration. In hemodiafiltration (HDF), the total amount of toxins removed is greater than in the individual processes, since convection and diffusion are not cumulative, but run in parallel and influence each other. HDF uses synthetic membranes that are more permeable (high-flux dialyzers) and have a better ultrafiltration performance.

A treatment method for dialysis patients in which the patient’s blood flows through plastic bloodlines into a special filter, the dialyzer. In the dialyzer, waste products from metabolic processes and excess water are removed from the blood and transported away in the dialysate. Afterwards, the purified blood is returned to the patient’s body. The process is controlled by a hemodialysis machine that pumps blood, adds anti-coagulants, regulates the purification process, and controls the mixing of the dialysate and its flow rate through the system. A patient typically receives three treatments per week, each lasting between three and six hours.

A form of treatment for patients with chronic kidney failure (kidney failure, chronic) that does not use dialysate. The solutes are removed by filtering the plasma water through a semi-permeable membrane by means of convective forces. A substitution fluid is infused to replace the volume removed by filtration.

Component of red blood cells that carries oxygen through the body.

Universal anticoagulant substance administered during hemodialysisto slow down blood coagulation.

A form of hemodiafiltration (HDF). With HighVolumeHDF, the volume of fluid substituted by convective transport is greater than with HDF. Recent studies show that HighVolumeHDF significantly increases patient survival rates compared to conventional dialysis treatment methods.

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

International organization for standardization.

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

Acute loss of renal function. Depending on the severity of renal function loss, dialysis treatment may be necessary temporarily. Unlike chronic kidney failure, dialysiscan help to completely restore kidney function in many patients with acute kidney failure.

Permanent failure of the kidney(terminal kidney failure) resulting from a slow and progressive loss of kidney function (detoxification of the body ceases) over several years. Since the renal function cannot be recovered, patients must be treated with renal replacement therapy, i.e. a 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.

KGaA -  A German legal business form equivalent to a partnership limited by shares. It is an entity with its own legal identity in which at least one general partner (personally liable shareholder, or “Komplementäraktionär”) has full liability toward the company’s creditors, while the other shareholders (“Kommanditaktionäre”) participate in the capital stock broken down into shares without being personally liable for the company’s debts.

Indicator to evaluate treatment quality. It is calculated by dividing the product of urea clearance through dialysis (K) and the duration of treatment (t) by the filtration rate of certain toxins (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 health care program developed by the U.S. Social Security Administration that reimburses health insurance companies and providers of medical services for the cost of medical care to individuals over 65, patients with chronic kidney failure (end-stage renal disease, ESRD), the disabled or needy.

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.

A treatment method that uses the patient’s peritoneum, i.e. the lining covering the inner wall of the abdominal cavity and the abdominal organs, as the dialyzing membrane. A sterile dialysateis introduced and removed through a catheter that has been surgically implanted into the patient’s abdominal cavity. The solution absorbs toxins and removes them together with excess water. Most treatments are supported by a machine – the cycler – and are administered by patients themselves at home or at work several times a day or during the night.

Drugs that bind excess phosphate in the intestine that has been ingested via food. Excess phosphate is normally discharged by healthy kidneys. In patients with chronic kidney failure (kidney failure, chronic), this filtering process can only partially be replaced by dialysis. Too much phosphate in the bloodcan cause numerous adverse effects, such as bone disease, thyroid problems and vascular calcification.

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.

Approach to completely restore diseased tissue to its original, healthy state. New technologies include lab-grown biomaterials, tissue engineering, stem cell- or gene therapies.

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.

A system offering the full range of automated peritoneal dialysisoptions while ensuring maximum safety and comfort for the patient, physician and nursing staff.

Price fluctuation of a security or currency.