Final answer:
The adequacy of hemodialysis can be compromised if the concentration gradient between the blood and the dialysate is not maintained, as it is necessary for the efficient diffusion of wastes like urea from the blood into the dialysate.
Step-by-step explanation:
The adequacy of hemodialysis treatment can be compromised by several factors, one of which relates to the concentration of solutes in the blood and the dialysate. During dialysis, urea and other waste products are filtered out of the blood by diffusion through a semipermeable membrane. For the dialysis to be effective, the concentration of solutes like urea should be high in the blood but low in the dialysate. This concentration gradient facilitates the movement of urea from the blood into the dialysate. In the upper component of the dialyzer—where blood is being cleaned—the concentration of urea is initially high but decreases as the blood moves through the machine. Conversely, in the lower compartment containing fresh dialysate, the concentration of urea should be kept low to maintain the concentration gradient necessary for diffusion. If the concentration gradient is not appropriately maintained, the efficiency of waste removal can decrease, compromising the adequacy of the treatment.