General Information

The Certificate in Dialysis Technician is a one-year paramedical program offered by Mahatma Gandhi Ayurvigyan Vidyapeeth. The course provides structured training in renal anatomy, principles of hemodialysis, and operation of dialysis machinery. Students learn essential protocols for patient monitoring, clinical safety, and infection control. Through rigorous clinical practicum, the curriculum prepares candidates to assist healthcare professionals in hemodialysis units efficiently.

1. Course Duration: 1 Year
2. Minimum Qualification: 10+2 pass with Science subjects
3. Course Category: PARAMEDICAL
4. Total Marks: 600 (Theory 600, 6 subjects)

Course Objectives

• Teach renal anatomy, renal physiology, and the clinical principles underlying hemodialysis procedures.
• Impart practical knowledge on setting up, operating, and maintaining modern hemodialysis equipment safely.
• Train students in vital sign monitoring, vascular access management, and pre-dialysis patient assessment.
• Instill strict adherence to infection control, sterilization protocols, and bio-medical waste management standards.

Learning Outcomes

• Demonstrate understanding of human renal anatomy and pathological conditions requiring dialysis treatment.
• Operate and troubleshoot standard hemodialysis machines and water treatment systems accurately.
• Monitor patient vital signs and manage minor clinical complications during dialysis sessions.
• Apply sterilization, disinfection, and infection prevention techniques within the dialysis unit.
• Assist nephrologists and senior clinical staff in executing safe dialysis procedures.

Pass & Division Criteria

The maximum marks and minimum pass marks of Theory and Practical of each subject are given in the Mark Distribution table below. To pass, a candidate must score the minimum pass marks separately in both Theory and Practical of every subject.

The division is decided on the aggregate percentage of marks obtained, as follows —

Mark Distribution

Total marks of the course : 600

Detailed Syllabus

1. Introduction to the Urinary System — Gross structural organization of kidneys, ureters, urinary bladder, urethra, and their general anatomical orientations within the human retroperitoneum.
2. Renal Gross Anatomy and Blood Supply — Internal structures including renal cortex, medulla, pyramids, calyces, renal pelvis, along with the renal artery, vein, and microvascular blood circulation.
3. Microscopic Anatomy of the Nephron — Detailed histology of cortical and juxtamedullary nephrons, Bowman's capsule, glomerulus, proximal tubule, loop of Henle, distal tubule, and collecting duct network.
4. Glomerular Filtration and Dynamics — Mechanisms of ultrafiltration, net filtration pressure, dynamics across glomerular capillary membranes, and clinical significance of Glomerular Filtration Rate measurements.
5. Tubular Reabsorption and Secretion Processes — Transport mechanisms across tubular epithelium, selective reabsorption of glucose, electrolytes, and water, alongside active tubular secretion of metabolic wastes and drugs.
6. Countercurrent Mechanism and Urine Concentration — Function of the loop of Henle and vasa recta in creating hypertonic medullary interstitium, regulating water balance, and forming concentrated urine.
7. Fluid, Electrolyte, and Acid-Base Regulation — Renal homeostasis of sodium, potassium, calcium, and phosphate ions, coupled with hydrogen ion excretion and bicarbonate reabsorption for maintaining physiological pH.
8. Endocrine and Metabolic Functions of Kidney — Production and endocrine action of renin, erythropoietin, and calcitriol, along with renal role in blood pressure control and calcium homeostasis.
9. Renal Pathophysiology and Renal Failure Overview — Pathophysiological changes in acute kidney injury and chronic kidney disease, uremic syndrome, and progression toward end-stage renal disease requiring dialysis therapy.

1. History and Overview of Hemodialysis — Historical evolution of extracorporeal blood purification, clinical indications for initiation of dialysis therapy, and basic terminology used in hemodialysis practice.
2. Principles of Diffusion and Concentration Gradients — Basic physics of passive solute transport, Fick's law, solute concentration gradients, and factors influencing solute clearance across semipermeable membranes.
3. Osmosis and Ultrafiltration Mechanisms — Mechanisms of solvent movement, hydrostatic and oncotic pressure generation, transmembrane pressure calculations, and fluid removal during clinical hemodialysis sessions.
4. Convection and Solute Drag Phenomenon — Principles of convective solute removal, bulk fluid flow dynamics, sieving coefficients, and clearance of middle-to-large molecular weight uremic toxins.
5. Dialyzer Membrane Structure and Characteristics — Synthetic and cellulose-based membranes, pore size, biocompatibility, membrane surface area, flux characteristics, and hollow-fiber dialyzer design considerations.
6. Composition and Preparation of Dialysate — Chemistry of bicarbonate and acid concentrates, proportioning with treated water, electrolyte composition, and role in correcting patient biochemical imbalances.
7. Extracorporeal Blood Circuit Dynamics — Components of the extracorporeal circuit, blood tubing segments, arterial and venous bubble traps, pressure monitoring sites, and circuit priming procedures.
8. Anticoagulation in Hemodialysis — Role of unfractionated heparin, low-molecular-weight heparin, regional citrate anticoagulation, clotting time monitoring, and management of dialysis-related bleeding risks.
9. Adequacy of Hemodialysis — Assessment parameters including urea reduction ratio, Kt/V modeling, blood sampling techniques, prescription adjustments, and factors leading to inadequate dialysis delivery.

1. Dialysis Machine Architecture and Modules — Comprehensive study of hydraulic system, blood delivery module, monitoring panels, microprocessors, and user interface controls of modern hemodialysis machines.
2. Water Treatment System Operation — Components of reverse osmosis plant, sand filters, water softeners, carbon beds, deionizers, membrane filtration, and daily purity quality testing.
3. Dialysis Machine Priming and Setup — Step-by-step procedures for stringing bloodlines, mounting dialyzers, physiological saline priming, debubbling, and configuring treatment parameters on console displays.
4. Pressure Transducers and Monitoring Alarms — Operation and calibration of arterial, venous, and transmembrane pressure sensors, including troubleshooting high and low limit circuit alarm triggers.
5. Air Detector and Blood Leak Sensors — Operating principles of ultrasonic air bubble detectors, optical venous clamp devices, photo-electric blood leak detectors, and machine protective interlocks.
6. Dialysate Delivery and Proportioning Systems — Operation of proportioning pumps, conductivity cells, temperature sensors, degasser units, and bypass valves ensuring safe delivery of dialysis fluids.
7. Disinfection and Sterilization Procedures — Chemical and thermal disinfection cycles of dialysis machines, machine surface sanitization, decalcification processes, and microbiological surveillance protocols.
8. Dialyzer Reprocessing and Reuse — Manual and automated reprocessing techniques, cleaning agents, volume testing, membrane integrity checks, chemical sterilization, and reuse storage regulations.
9. Preventive Maintenance and Electrical Safety — Routine preventive inspection schedules, calibration procedures, electrical leakage testing, battery backup inspection, and biomedical equipment handling standards.

1. Pre-Dialysis Patient Assessment — Evaluation of pre-dialysis vital signs, baseline dry weight determination, interdialytic weight gain calculation, fluid overload assessment, and physical examination.
2. Vascular Access Cannulation and Assessment — Techniques for physical inspection of AV fistulas and grafts, palpation of thrill, auscultation of bruit, aseptic cannulation techniques, and catheter care.
3. Intra-Dialytic Vital Signs Monitoring — Periodic recording of blood pressure, heart rate, respiration, oxygen saturation, temperature, and recognizing early warning signs of hemodynamic instability.
4. Fluid Balance and Ultrafiltration Profiling — Monitoring real-time ultrafiltration rates, managing fluid removal targets, adjusting sodium profiling, and assessing patient response to intravascular volume shifts.
5. Management of Intra-Dialytic Hypotension — Causes, early symptoms, immediate nursing and technician interventions, infusion of saline boluses, positioning adjustments, and preventative ultrafiltration adjustments.
6. Monitoring for Acute Dialytic Complications — Detection and immediate emergency management of muscle cramps, nausea, vomiting, chest pain, dialysis disequilibrium syndrome, and pyrogenic reactions.
7. Vascular Access Complications and Alarms — Troubleshooting venous pressure elevation, poor arterial blood flow, needle displacement, hematoma formation, recirculation issues, and line disconnection hazards.
8. Post-Dialysis Evaluation and Discharge — Post-dialysis weight verification, orthostatic blood pressure check, post-treatment bleeding control from access puncture sites, and patient discharge instructions.
9. Infection Control and Documentation Standards — Standard universal precautions, management of hepatitis B and C positive patients, proper waste segregation, and accurate clinical dialysis charting.

1. Introduction to Microbiology and Infection — Basic concepts of microorganisms, transmission of pathogens, and principles of infection control in hospital and healthcare environments.
2. Standard Precautions and Hand Hygiene — Techniques of medical and surgical handwashing, alcohol rubs, usage of personal protective equipment, and compliance protocols in dialysis units.
3. Blood-Borne Pathogens and High-Risk Viruses — Risks of hepatitis B, hepatitis C, and HIV transmission, universal precautions, immunization protocols, and post-exposure prophylaxis for healthcare staff.
4. Dialysis Water Treatment and Microbiological Testing — Microbial contamination risks in RO water systems, endotoxin testing methods, bacterial cultures, and standards for dialysis water purity.
5. Sterilization and Disinfection of Dialysis Equipment — Methods of chemical sterilization, thermal disinfection of hemodialysis machines, reprocessing of dialyzers, and disinfection of dialysis fluid pathways.
6. Vascular Access Site Infection Prevention — Aseptic techniques for cannulation, catheter dressing changes, exit-site infection recognition, catheter-related bloodstream infection prevention, and surveillance protocols.
7. Isolation Protocols for Infectious Dialysis Patients — Dedicated machine allocation, isolation room management, barrier nursing, and specific disinfection protocols for hepatitis and multi-drug resistant organisms.
8. Biomedical Waste Management in Dialysis — Segregation of infectious sharp and non-sharp waste, color coding rules, safe disposal of dialyzers, tubing, and statutory compliance.
9. Environmental Cleaning and Spill Management — Sanitization of dialysis chairs, machine surfaces, management of blood and fluid spills using hypochlorite solutions, and terminal cleaning procedures.
10. Surveillance, Audit, and Needle-Stick Injury — Recording infection rates, internal audits, needle-stick injury protocols, mandatory reporting, root cause analysis, and ongoing staff quality training.

1. Patient Assessment and Pre-Dialysis Evaluation — Measuring baseline vital signs, assessing dry weight, evaluating fluid overload symptoms, reviewing laboratory results, and documenting pre-dialysis parameters.
2. Priming and Dialysis Machine Preparation — Safety checks, circuit assembling, physiological saline priming, transducer protector alignment, alarm calibration, and dialysate flow rate verification.
3. Vascular Access Cannulation and Management — Aseptic arteriovenous fistula cannulation, buttonhole technique, central venous catheter handling, heparin lock instillation, and access patency monitoring.
4. Initiation and Intra-Dialytic Patient Monitoring — Starting blood pump, connecting vascular lines, setting ultrafiltration rates, monitoring vital signs, blood circuit stability, and venous pressure trends.
5. Management of Acute Intra-Dialytic Complications — Recognizing and managing hypotension, muscle cramps, dysequilibrium syndrome, air embolism, dialyzer reactions, and sudden vascular access dislodgement.
6. Termination of Hemodialysis Session — Blood restitution procedures using saline, needle withdrawal techniques, application of pressure dressings, post-dialysis weight verification, and documentation.
7. Dialyzer Reprocessing and Header Cleaning — Manual and automated dialyzer reuse protocols, header cleaning, volume testing, chemical disinfectant filling, and labeling for specific patients.
8. Peritoneal Dialysis Clinical Procedures — Assisting in continuous ambulatory peritoneal dialysis, sterile exchange methods, catheter exit-site care, effluent bag inspection, and transfer set maintenance.
9. Emergency Response and Resuscitation in Dialysis — Basic life support, managing cardiac arrest during dialysis, emergency line disconnection protocols, handling machine failures, and fire evacuation procedures.
10. Patient Documentation and Quality Assurance Audits — Maintaining dialysis chart records, recording machine logs, calculating Kt/V urea clearance, incident reporting, and participating in unit quality audits.