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Dialysis
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This article is about renal dialysis. For other uses, see Dialysis (disambiguation).
Renal Dialysis
Patient receiving hemodialysis
Specialty
nephrology
ICD-9-CM
39.95
MeSH
D006435
MedlinePlus
00743
[edit on Wikidata]
In medicine, dialysis (from Greek διάλυσις, diàlysis, "dissolution"; from διά, dià, "through", and λύσις, lỳsis, "loosening or splitting") is the process of removing excess water, solutes and toxins from the blood in those whose native kidneys have lost the ability to perform these functions in a natural way. This is referred to as renal replacement therapy.
Dialysis may be used in those with rapidly developing loss of kidney function, called acute kidney injury (previously called acute renal failure); or slowly worsening kidney function, called Stage 5 chronic kidney disease, (previously called chronic kidney failure and end-stage renal disease and end-stage kidney disease).
Dialysis is used as a temporary measure in either acute kidney injury or in those awaiting kidney transplant and as a permanent measure in those for whom a transplant is not indicated or not possible.[1]
In the United Kingdom and the United States, dialysis is paid for by the government for those that are eligible. The first successful dialysis was performed in 1943.
In research laboratories, dialysis technique can also be used to separate molecules based on their size. Additionally, it can be used to balance buffer between sample and the solution "dialysis bath" or "dialysate"[2] that the sample is in. For dialysis in a laboratory semipermeable membrane is used as a tube made of cellulose acetate or nitrocellulose[3] where pore size can vary according to the size separation required. Control over pore size allows a better separation between small molecules while leaving large molecules of interest inside. Solvents, ions diffuse easily through the pores while leaving the big molecules behind and separate.[clarification needed] In protein purification technique dialysis is used to exchange buffers, loose smaller proteins that can pass through the pores, dilutions of concentrated salts, while leaving the protein of interest inside the semipermeable membrane separated.
Contents
[hide]
1 Background
2 Principle
3 Types
3.1 Hemodialysis
3.2 Peritoneal dialysis
3.3 Hemofiltration
3.4 Hemodiafiltration
3.5 Intestinal dialysis
4 Indications
4.1 Acute indications
4.2 Chronic indications
5 Dialyzable substances
5.1 Characteristics
5.2 Substances
6 Paediatric dialysis
7 Funding sources
7.1 In the United Kingdom
7.2 In the United States
7.3 In China
8 History
9 See also
9.1 Materials and methods
9.2 Medical applications
10 References
11 Bibliography
12 Further reading
13 External links
Background[edit]
A hemodialysis machine
The kidneys have an important role in maintaining health. When the person is healthy, the kidneys maintain the body's internal equilibrium of water and minerals (sodium, potassium, chloride, calcium, phosphorus, magnesium, sulfate). The acidic metabolism end-products that the body cannot get rid of via respiration are also excreted through the kidneys. The kidneys also function as a part of the endocrine system, producing erythropoietin, calcitriol and renin. Erythropoietin is involved in the production of red blood cells and calcitriol plays a role in bone formation.[4] Dialysis is an imperfect treatment to replace kidney function because it does not correct the compromised endocrine functions of the kidney. Dialysis treatments replace some of these functions through diffusion (waste removal) and ultrafiltration (fluid removal).[5] Dialysis uses highly purified (also known as "ultrapure") water.[6]
Principle[edit]
Dialysis works on the principles of the diffusion of solutes and ultrafiltration of fluid across a semi-permeable membrane. Diffusion is a property of substances in water; substances in water tend to move from an area of high concentration to an area of low concentration.[7] Blood flows by one side of a semi-permeable membrane, and a dialysate, or special dialysis fluid, flows by the opposite side. A semipermeable membrane is a thin layer of material that contains holes of various sizes, or pores. Smaller solutes and fluid pass through the membrane, but the membrane blocks the passage of larger substances (for example, red blood cells, large proteins). This replicates the filtering process that takes place in the kidneys when the blood enters the kidneys and the larger substances are separated from the smaller ones in the glomerulus.[7]
Osmosis diffusion ultrafiltration and dialysis
The two main types of dialysis, hemodialysis and peritoneal dialysis, remove wastes and excess water from the blood in different ways.[1] Hemodialysis removes wastes and water by circulating blood outside the body through an external filter, called a dialyzer, that contains a semipermeable membrane. The blood flows in one direction and the dialysate flows in the opposite. The counter-current flow of the blood and dialysate maximizes the concentration gradient of solutes between the blood and dialysate, which helps to remove more urea and creatinine from the blood. The concentrations of solutes (for example potassium, phosphorus and urea) are undesirably high in the blood, but low or absent in the dialysis solution, and constant replacement of the dialysate ensures that the concentration of undesired solutes is kept low on this side of the membrane. The dialysis solution has levels of minerals like potassium and calcium that are similar to their natural concentration in healthy blood. For another solute, bicarbonate, dialysis solution level is set at a slightly higher level than in normal blood, to encourage diffusion of bicarbonate into the blood, to act as a pH buffer to neutralize the metabolic acidosis that is often present in these patients. The levels of the components of dialysate are typically prescribed by a nephrologist according to the needs of the individual patient.
In peritoneal dialysis, wastes and water are removed from the blood inside the body using the peritoneum as a natural semipermeable membrane. Wastes and excess water move from the blood, across the peritoneal membrane and into a special dialysis solution, called dialysate, in the abdominal cavity.
Types[edit]
There are three primary and two secondary types of dialysis: hemodialysis (primary), peritoneal dialysis (primary), hemofiltration (primary), hemodiafiltration (secondary) and intestinal dialysis (secondary).
Hemodialysis[edit]
Main article: Hemodialysis
In hemodialysis, the patient's blood is pumped through the blood compartment of a dialyzer, exposing it to a partially permeable membrane. The dialyzer is composed of thousands of tiny hollow synthetic fibers. The fiber wall acts as the semipermeable membrane. Blood flows through the fibers, dialysis solution flows around the outside of the fibers, and water and wastes move between these two solutions.[8] The cleansed blood is then returned via the circuit back to the body. Ultrafiltration occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is done by applying a negative pressure to the dialysate compartment of the dialyzer. This pressure gradient causes water and dissolved solutes to move from blood to dialysate and allows the removal of several litres of excess fluid during a typical 4-hour treatment. In the United States, hemodialysis treatments are typically given in a dialysis center three times per week (due in the United States to Medicare reimbursement rules); however, as of 2005 over 2,500 people in the United States are dialyzing at home more frequently for various treatment lengths.[9] Studies have demonstrated the clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. This type of hemodialysis is usually called "nocturnal daily hemodialysis", which a study has shown a significant improvement in both small and large molecular weight clearance and decrease the requirement of taking phosphate binders.[10] These frequent long treatments are often done at home while sleeping, but home dialysis is a flexible modality and schedules can be changed day to day, week to week. In general, studies have shown that both increased treatment length and frequency are clinically beneficial.[11]
Hemo-dialysis was one of the most common procedures performed in U.S. hospitals in 2011, occurring in 909,000 stays (a rate of 29 stays per 10,000 population).[12]
Peritoneal dialysis[edit]
Schematic diagram of peritoneal dialysis
Main article: Peritoneal dialysis
In peritoneal dialysis, a sterile solution containing glucose (called dialysate) is run through a tube into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal membrane acts as a partially permeable membrane.(eluma,2017)
This exchange is repeated 4–5 times per day; automatic systems can run more frequent exchange cycles overnight. Peritoneal dialysis is less efficient than hemodialysis, but because it is carried out for a longer period of time the net effect in terms of removal of waste products and of salt and water are similar to hemodialysis. Peritoneal dialysis is carried out at home by the patient, often without help. This frees patients from the routine of having to go to a dialysis clinic on a fixed schedule multiple times per week. Peritoneal dialysis can be performed with little to no specialized equipment (other than bags of fresh dialysate).
Hemofiltration[edit]
Main article: Hemofiltration
Continuous veno-venous haemofiltration with pre- and post-dilution (CVVH)
Hemofiltration is a similar treatment to hemodialysis, but it makes use of a different principle. The blood is pumped through a dialyzer or "hemofilter" as in dialysis, but no dialysate is used. A pressure gradient is applied; as a result, water moves across the very permeable membrane rapidly, "dragging" along with it many dissolved substances, including ones with large molecular weights, which are not cleared as well by hemodialysis. Salts and water lost from the blood during this process are replaced with a "substitution fluid" that is infused into the extracorporeal circuit during the treatment.
Hemodiafiltration[edit]
Hemodiafiltration is a combination of hemodialysis and hemofiltration, thus used to purify the blood from toxins when the kidney is not working normally and also used to treat acute kidney injury (AKI).
Intestinal dialysis[edit]
Continuous veno-venous haemodiafiltration (CVVHDF)
In intestinal dialysis, the diet is supplemented with soluble fibres such as acacia fibre, which is digested by bacteria in the colon. This bacterial growth increases the amount of nitrogen that is eliminated in fecal waste.[13][14][15] An alternative approach utilizes the ingestion of 1 to 1.5 liters of non-absorbable solutions of polyethylene glycol or mannitol every fourth hour.[16]
Indications[edit]
The decision to initiate dialysis or hemofiltration in patients with kidney failure depends on several factors. These can be divided into acute or chronic indications.
Acute indications[edit]
Indications for dialysis in the patient with acute kidney injury are summarized with the vowel mnemonic of "AEIOU":[17]
Acidemia from metabolic acidosis in situations in which correction with sodium bicarbonate is impractical or may result in fluid overload.
Electrolyte abnormality, such as severe hyperkalemia, especially when combined with AKI.
Intoxication, that is, acute poisoning with a dialyzable substance. These substances can be represented by the mnemonic SLIME: salicylic acid, lithium, isopropanol, magnesium-containing laxatives and ethylene glycol.
Overload of fluid not expected to respond to treatment with diuretics
Uremia complications, such as pericarditis, encephalopathy, or gastrointestinal bleeding.
Chronic indications[edit]
Chronic dialysis may be indicated when a patient has symptomatic kidney failure and low glomerular filtration rate (GFR < 15 mL/min).[18] Between 1996 and 2008, there was a trend to initiate dialysis at progressively higher estimated GFR, eGFR. A review of the evidence shows no benefit or potential harm with early dialysis initiation, which has been defined by start of dialysis at an estimated GFR of greater than 10ml/min/1.732. Observational data from large registries of dialysis patients suggests that early start of dialysis may be harmful.[19] The most recent published guidelines from Canada, for when to initiate dialysis, recommend an intent to defer dialysis until a patient has definite kidney failure symptoms, which may occur at an estimated GFR of 5-9ml/min/1.732.[20]
Dialyzable substances[edit]
Characteristics[edit]
Dialyzable substances, substances which can be removed using dialysis, have following properties:
low molecular mass
high water solubility
low protein binding capacity
prolonged elimination (long half-life)
small volume of distribution
Substances[edit]
Ethylene glycol
Procainamide
Methanol
Isopropyl alcohol
Barbiturates
Lithium
Bromide
Sotalol
Chloral hydrate
Ethanol
Acetone
Atenolol
Theophylline
Salicylates
Paediatric dialysis[edit]
Over the past 20 years, children have benefited from major improvements in both technology and clinical management of dialysis. Morbidity during dialysis sessions has decreased with seizures being exceptional and hypotensive episodes rare. Pain and discomfort have been reduced with the use of chronic internal jugular venous catheters and anesthetic creams for fistula puncture. Non-invasive technologies to assess patient target dry weight and access flow can significantly reduce patient morbidity and health care costs.
Biocompatible synthetic membranes, specific small size material dialyzers and new low extra-corporeal volume tubing have been developed for young infants. Arterial and venous tubing length is made of minimum length and diameter, a <80ml to <110ml volume tubing is designed for pediatric patients and a >130 to <224ml tubing are for adult patients, regardless of blood pump segment size, which can be of 6.4mm for normal dialysis or 8.0mm for high flux dialysis in all patients. All dialysis machine manufacturers design their machine to do the pediatric dialysis. In pediatric patients, the pump speed should be kept at low side, according to patient blood output capacity, and the clotting with heparin dose should be carefully monitored. The high flux dialysis (see below) is not recommended for pediatric patients.
In children, hemodialysis has to be individualized and viewed as an "integrated therapy" considering their long-term exposure to chronic renal failure treatment. Dialysis is seen only as a temporary measure for children compared with renal transplantation because this enables the best chance of rehabilitation in terms of educational and psychosocial functioning.long-term chronic dialysis, however, the highest standards should be applied to these children to preserve their future "cardiovascular life" which might include more dialysis time and on-line hemodiafiltration online hdf with synthetic high flux membranes with the surface area of 0.2sq.m to 0.8sq.m and blood tubing lines with the low volume yet large blood pump segment of 6.4/8.0mm, if we are able to improve on the rather restricted concept of small-solute urea dialysis clearance.
Funding sources[edit]
This section needs expansion. You can help by adding to it. (March 2017)
In the United Kingdom[edit]
The National Health Service provides dialysis in the United Kingdom. In England the service is commissioned by NHS England. About 23,000 patients use the service each year.[21]
In the United States[edit]
Since 1972, the United States has covered the cost of dialysis and transplants for all citizens. By 2014, more than 460,000 Americans were undergoing treatment, the costs of which amount to 6 percent of the entire Medicare budget. Kidney disease is the ninth leading cause of death, and the U.S. has one of the highest mortality rates for dialysis care in the industrialized world. The rate of patients getting kidney transplants has been lower than expected. These outcomes have been blamed on a new for-profit dialysis industry responding to government payment policies.[22][23][24] A 1999 study concluded that "patients treated in for-profit dialysis facilities have higher mortality rates and are less likely to be placed on the waiting list for a renal transplant than are patients who are treated in not-for-profit facilities", possibly because transplantation removes a constant stream of revenue from the facility.[25] The insurance industry has complained about kickbacks and problematic relationships between charities and providers.[26]
In China[edit]
The Government of China provides the funding for dialysis treatment. There is a challenge to reach everyone who needs dialysis treatment because of the unequal distribution of health care resources and dialysis centers.[27] There are 395,121 individuals who receive hemodialysis or peritoneal dialysis in China per year. The percentage of the Chinese population with chronic kidney disease is 10.8%.[28] The Chinese Government is trying to increase the amount of peritoneal dialysis taking place in order to meet the needs of the individuals with chronic kidney disease in their country.[29]
History[edit]
Arm hooked up to dialysis tubing.
A Dutch doctor, Willem Johan Kolff, constructed the first working dialyzer in 1943 during the Nazi occupation of the Netherlands.[30] Due to the scarcity of available resources, Kolff had to improvise and build the initial machine using sausage casings, beverage cans, a washing machine and various other items that were available at the time. Over the following two years (1943–1945), Kolff used his machine to treat 16 patients suffering from acute kidney failure, but the results were unsuccessful. Then, in 1945, a 67-year-old comatose woman regained consciousness following 11 hours of hemodialysis with the dialyzer and lived for another seven years before dying from an unrelated condition. She was the first-ever patient successfully treated with dialysis.[30] Nils Alwall modified a similar construction to the Kolff dialysis machine by enclosing it inside a stainless steel canister. This allowed the removal of fluids, by applying a negative pressure to the outside canister, thus making it the first truly practical device for hemodialysis. Alwall treated his first patient in acute kidney failure on 3 September 1946.[citation needed]
See also[edit]
Materials and methods[edit]
Thomas Graham (chemist), the founder of dialysis and father of colloid chemistry
Dialysis tubing
List of US dialysis providers
Medical applications[edit]
Apheresis, also known as plasmapheresis, is another extracorporeal technique that selectively removes specific constituents from blood
Hemodialysis
Peritoneal dialysis
Acute kidney failure
Kidney failure
Nephrology
Chronic kidney disease
Hepatorenal syndrome
References[edit]
^ Jump up to: a b Pendse S, Singh A, Zawada E. Initiation of Dialysis. In: Handbook of Dialysis. 4th ed. New York, NY; 2008:14–21
Jump up ^ Garrett, Reginald H.; Grisham, Charles M. (2013). Biochemistry (5th ed.). p. 107. ISBN 978-1-133-10629-6.
Jump up ^ Ninfa, Alexander J.; Ballou, David P.; Benore, Marilee (2009). Fundamental Laboratory Approaches for Biochemistry and Biotechnology (2nd ed.). p. 45. ISBN 978-0-470-08766-4.
Jump up ^ Brundage D. Renal Disorders. St. Louis, MO: Mosby; 1992
Jump up ^ "Atlas of Diseases of the Kidney, Volume 5, Principles of Dialysis: Diffusion, Convection, and Dialysis Machines" (PDF). Retrieved 2011-09-02.
Jump up ^ "Home Hemodialysis and Water Treatment". Davita. Retrieved 3 June 2017.
^ Jump up to: a b Mosby’s Dictionary of Medicine, Nursing, & Health Professions. 7th ed. St. Louis, MO; Mosby: 2006
Jump up ^ Ahmad S, Misra M, Hoenich N, Daugirdas J. Hemodialysis Apparatus. In: Handbook of Dialysis. 4th ed. New York, NY; 2008:59-78.
Jump up ^ "USRDS Treatment Modalities" (PDF). United States Renal Data System. Retrieved 2011-09-02.
Jump up ^ Rocco, MV (July 2007). "More Frequent Hemodialysis: Back to the Future?". Advances in Chronic Kidney Disease. 14 (3): e1–9. doi:10.1053/j.ackd.2007.04.006. PMID 17603969.
Jump up ^ Daily therapy study results compared Archived March 5, 2011, at the Wayback Machine.
Jump up ^ Pfuntner A., Wier L.M., Stocks C. Most Frequent Procedures Performed in U.S. Hospitals, 2011. HCUP Statistical Brief #165. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. [1].
Jump up ^ "Access". Medscape. Retrieved 2011-09-02.
Jump up ^ "Access". Medscape. Retrieved 2011-09-02.
Jump up ^ "Access". Medscape. Retrieved 2011-09-02.
Jump up ^ "Access". Medscape. Retrieved 2011-09-02.
Jump up ^ Irwin, Richard S.; James M. Rippe (2008). Irwin and Rippe's intensive care medicine. Lippincott Williams & Wilkins. pp. 988–999. ISBN 978-0-7817-9153-3.
Jump up ^ Tattersall, James; Dekker, Friedo; Heimbürger, Olof; Jager, Kitty J.; Lameire, Norbert; Lindley, Elizabeth; Van Biesen, Wim; Vanholder, Raymond; Zoccali, Carmine (2011-07-01). "When to start dialysis: updated guidance following publication of the Initiating Dialysis Early and Late (IDEAL) study". Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association. 26 (7): 2082–2086. doi:10.1093/ndt/gfr168. ISSN 1460-2385. PMID 21551086.
Jump up ^ Rosansky, Steven; Glassock, Richard; Clark, William (2011). "Early Start of Dialysis: A Critical Review". Clin J Am Soc Nephrol. 6: 1222–1228. doi:10.2215/cjn.09301010.
Jump up ^ Nesrallah, Gihad (Feb 2014). "Canadian Society of Nephrology 2014 clinical practice guideline for timing the initiation of chronic al indications for chronic dialysis". CMAJ. 186: 112–117. doi:10.1503/cmaj.130363. PMC 3903737  .
Jump up ^ "Specialised service transfer reconsidered due to incorrect data". Health Service Journal. 13 March 2015. Retrieved 20 April 2015.
Jump up ^ Fields, Robin (2010-11-09). "In Dialysis, Life-Saving Care at Great Risk and Cost". ProPublica. Retrieved 2017-05-18.
Jump up ^ "John Oliver sees ills in for-profit dialysis centers". Newsweek. 2017-05-15. Retrieved 2017-05-18.
Jump up ^ "Profit motive linked to dialysis deaths - UB Reporter". www.buffalo.edu. Retrieved 2017-05-18.
Jump up ^ Garg, Pushkal P.; Frick, Kevin D.; Diener-West, Marie; Powe, Neil R. (1999-11-25). "Effect of the Ownership of Dialysis Facilities on Patients' Survival and Referral for Transplantation". New England Journal of Medicine. 341 (22): 1653–1660. doi:10.1056/NEJM199911253412205. ISSN 0028-4793. PMID 10572154.
Jump up ^ Abelson, Reed; Thomas, Katie (2016-07-01). "UnitedHealthcare Sues Dialysis Chain Over Billing". The New York Times. ISSN 0362-4331. Retrieved 2017-05-18.
Jump up ^ JIN, Jian; WANG, Jianxiang; MA, Xiaoyi; WANG, Yuding; LI, Renyong (April 2015). "Equality of Medical Health Resource Allocation in China Based on the Gini Coefficient Method". Iranian Journal of Public Health. 44 (4): 445–457. ISSN 2251-6085. PMC 4441957  . PMID 26056663.
Jump up ^ Zhang, Luxia; Wang, Fang; Wang, Li; Wang, Wenke; Liu, Bicheng; Liu, Jian; Chen, Menghua; He, Qiang; Liao, Yunhua (2012-03-03). "Prevalence of chronic kidney disease in China: a cross-sectional survey". The Lancet. 379 (9818): 815–822. doi:10.1016/S0140-6736(12)60033-6.
Jump up ^ Li, Philip Kam-Tao; Lui, Sing Leung; Ng, Jack Kit-Chung; Cai, Guan Yan; Chan, Christopher T; Chen, Hung Chun; Cheung, Alfred K; Choi, Koon Shing; Choong, Hui Lin (2017-12-01). "Addressing the burden of dialysis around the world: A summary of the roundtable discussion on dialysis economics at the First International Congress of Chinese Nephrologists 2015". Nephrology. 22: 3–8. doi:10.1111/nep.13143. ISSN 1440-1797.
^ Jump up to: a b "Willem Kolff, Doctor Who Invented Kidney and Heart Machines, Dies at 97". New York Times. 12 February 2009.
Bibliography[edit]
Al-Mosawi A. J. (2004). "Acacia gum supplementation of a low-protein diet in children with end-stage renal disease". Pediatric Nephrology. 19 (10): 1156–1159. doi:10.1007/s00467-004-1562-5.
Al Mosawi A. J. (2007). "The use of acacia gum in end stage renal failure". Journal of tropical pediatrics. 53 (5): 362–365. doi:10.1093/tropej/fmm033.
Ali A. A.; Ali K. E.; Fadlalla A. E.; Khalid K. E. (2008). "The effects of gum arabic oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan". Natural product research. 22 (1): 12–21. doi:10.1080/14786410500463544.
Miskowiak J (1991). "Continuous Intestinal Dialysis for Uraemia by Intermittent Oral Intake of Non-Absorbable Solutions: An Experimental Study". Scandinavian journal of urology and nephrology. 25 (1): 71–74. doi:10.3109/00365599109024532.
Further reading[edit]
Stefania Crowther; Lois Reynolds; Tilli Tansey, eds. (2009), History of Dialysis in the UK: c. 1950-1980, Wellcome Witnesses to Contemporary Medicine, History of Modern Biomedicine Research Group, ISBN 978-0-85484-122-6 , Wikidata Q29581768
External links[edit]
Find more aboutDialysisat Wikipedia's sister projects
Definitions from Wiktionary
Media from Wikimedia Commons
News from Wikinews
Quotations from Wikiquote
Texts from Wikisource
Textbooks from Wikibooks
Learning resources from Wikiversity
Machine Cleans Blood While You Wait—1950 article on early use of dialysis machine at Bellevue Hospital New York City—i.e. example of how complex and large early dialysis machines were
Home Dialysis Museum—History and pictures of dialysis machines through time
Introduction to Dialysis Machines—Tutorial describing the main subfunctions of dialysis systems.
First Nations man conducts own dialysis treatments to avoid move to the city—CBC News (November 30, 2016)
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text:
Degrassi: Next Class
From Wikipedia, the free encyclopedia
Jump to: navigation, search
For other series, see Degrassi (franchise).
Not to be confused with Degrassi: The Next Generation.
Degrassi: Next Class
Degrassi: Next Class 2nd current official logo
Genre
Teen drama
Created by
Linda Schuyler
Yan Moore
Stephen Stohn
Sarah Glinski
Matt Huether
Theme music composer
Jody Colero
Jim McGrath
Shobha
Stephen Stohn
Rob Wells
Opening theme
"Whatever It Takes"
Composer(s)
Jim McGrath
Tim Welch
Country of origin
Canada
Original language(s)
English
No. of seasons
4
No. of episodes
40 (list of episodes)
Production
Executive producer(s)
Linda Schuyler
Stephen Stohn
Brendon Yorke
Sarah Glinski
Matt Huether
Producer(s)
Stefan Brogren
Courtney Jane Walker
Stephanie Williams
Location(s)
Toronto, Ontario
Editor(s)
Jason B. Irvine
Nicholas Wong
Running time
24 minutes
Production company(s)
Epitome Pictures
DHX Media
Distributor
Entertainment One
(Canada)
DHX Media
(International)
Release
Original network
Family (F2N)/Family Channel App (Canada)
Netflix (International)
Picture format
HDTV
Original release
January 4, 2016 – present
Chronology
Preceded by
Degrassi: The Next Generation
School's Out
Degrassi High
Degrassi Junior High
Related shows
The Kids of Degrassi Street
Degrassi Talks
External links
Website
Degrassi: Next Class is a Canadian teen drama television series set in the Degrassi Universe, which was originally created by Linda Schuyler and Kit Hood in 1979. It is the fifth series in the Degrassi franchise, following The Kids of Degrassi Street, Degrassi Junior High, Degrassi High, and Degrassi: The Next Generation. The series was created by Linda Schuyler, Stephen Stohn, Sarah Glinski, and Matt Huether and is produced by Epitome Pictures (a subsidiary of DHX Media).[1] The current executive producers are Schuyler, her husband Stephen Stohn, Sarah Glinski, and Matt Huether. The series is filmed at Epitome's studios in Toronto, Ontario, rather than on the real De Grassi Street from which the franchise takes its name.
The first season of Next Class premiered on January 4, 2016 on Family's new teen programming block, F2N in Canada. The series saw its U.S. (and international) debut January 15, 2016, on Netflix. In Australia the show premiered on ABC3 on May 16, 2016. Season one ended on January 17, 2016 for both the Family Channel's two weeks or a fortnight run and Netflix's five hours to three days run.
The fourth season was streamed on the Family Channel App on June 30, 2017 with the episodes beginning to air daily on July 3, 2017. The series was then released on Netflix on July 7, 2017.[2][3][4]
Although not officially confirmed by the networks, series co-creator Linda Schuyler has stated that brainstorming is underway for seasons five and six of Next Class.[5] New series leads and recurring characters were also cast to join the series.[6]
Contents
[hide]
1 Overview
2 Episodes
3 Cast
3.1 Main
3.2 Guest appearances
4 Production
4.1 Concept
4.2 Executive producers, script-writers and directors
4.3 Episode format
4.4 Opening sequence
4.5 Filming locations
5 Broadcast
6 Notes
7 References
8 External links
Overview[edit]
Like its predecessors, the series follows an ensemble cast of students at Degrassi Community School who face various challenges often seen as taboo such as graffiti, sex, teen pregnancy, bullying, date rape, drug abuse, mental health, self image, homosexuality, self-injury, suicide, abortion, domestic violence, death, racism and many other issues.
Episodes[edit]
Main article: List of Degrassi: Next Class episodes
Season
Episodes
Netflix
Canadian release
Released
First aired
Last aired
1 10 January 15, 2016[7][8] January 4, 2016[9][1] January 15, 2016
2 10 July 22, 2016[10] July 19, 2016 September 20, 2016
3 10 January 6, 2017[11] January 9, 2017[12] January 20, 2017
4 10 July 7, 2017[13] July 3, 2017a[14] July 14, 2017
^a Season 4 of Degrassi: Next Class streamed on the Family Channel App on June 30, 2017, four days before its debut on the channel.
Cast[edit]
Main article: List of Degrassi: Next Class characters
Main[edit]
Starting with season 1 of Next Class, none of the characters who debuted during the changes happening in seasons eight and nine of The Next Generation remain. The students featured were introduced starting in seasons eleven, thirteen, and fourteen of the previous incarnation along with several new characters for the follow-up series. The first and second seasons featured 19 regular roles, with 14 cast members returning from season 14 of Degrassi. Keeping ties to the early seasons of the previous incarnation and the franchise as a whole, Stefan Brogren's character remains the Principal of Degrassi Community School. According to Amir Bageria, the currently renewed season four will be the last season for a majority of the first cast of Next Class as their characters graduate.[15] Seasons three and four added two regulars to the cast, as casting calls were made public through Larissa Mair Casting.[16]
On October 21, 2016, it was confirmed that the cast members in a photo executive producer Stephen Stohn posted were the ones leaving the cast at the end of season four. This includes: Eric Osborne (Miles Hollingsworth III), Ricardo Hoyos (Zig Novak), Andre Kim (Winston Chu), Ehren Kassam (Jonah Haak), Ana Golja (Zoe Rivas), Lyle Lettau (Tristan Milligan), Nikki Gould (Grace Cardinal), Olivia Scriven (Maya Matlin), Richard Walters (Tiny Bell) and Soma Bhatia (Goldi Nahir).[17][18]
Guest appearances[edit]
Several recurring cast members from the previous incarnation continued their roles in Degrassi: Next Class, a majority being the parents and teachers of the students at Degrassi Community School. David Sutcliffe of Gilmore Girls fame appeared in a season one episode as himself. In season two, several cast members from the first incarnation made guest appearances for the 500th episode of the Degrassi franchise. These cast members include Adamo Ruggiero as Marco Del Rossi, Miriam McDonald as Emma Nelson, Lauren Collins as Paige Michalchuk, Shane Kippel as Gavin "Spinner" Mason, and Sarah Barrable-Tishauer as Liberty Van Zandt.[19] Jamie Johnston, who portrayed Peter Stone in seasons five through ten of Degrassi: The Next Generation, also made his return for the second season, appearing in several episodes. Other previous cast members that appeared include Raymond Ablack as Sav Bhandari, Charlotte Arnold as Holly J. Sinclair, Jake Epstein as Craig Manning, and Jacob Neayem as Mo Mashkour.[20] In season 3 and 4, Chloe Rose reprised her role for three episodes as Katie Matlin. Epstein also made a return guest appearance in season 4.
Production[edit]
Concept[edit]
The original idea for "Degrassi: Next Class" was to be the fifteenth season of Degrassi: The Next Generation, but under a new title. In an interview with Vice, Linda Schuyler, founder of Epitome and one of the producers of the original The Kids of Degrassi Street said "We realized that the kids we're talking to today are a new generation from the kids we talked to in 2001 when we came out with Degrassi: The Next Generation. Then, we were very much talking to millennials. There's a new generation, Generation Z, who weren't even born when we started that show. That was a very sobering fact...We've done a lot of research into Generation Z and decided we need a reboot."[21]
When Degrassi: The Next Generation ended its run on TeenNick in the United States, the producers sought out other means to distribute the Next Class series and later made a deal with Netflix.[22]
Executive producers, script-writers and directors[edit]
Epitome Pictures, DHX Media, and Netflix jointly produce the series with funding from the Shaw Rocket Fund, Royal Bank of Canada and the Cogeco Program Development Fund.
Franchise co-creator Linda Schuyler and her husband Stephen Stohn serve as executive producers for the series. Other executive producers include Sarah Glinkski, Matt Huether and Brendon Yorke.
Continuing with Next Class, Sarah Glinski and Matt Huether serve as head story editors for the show. Other writers include Courtney Jane Walker, Alejandro Alcoba, Cole Bastedo. Jennifer Kassabian and Ian MacIntyre. Current directors for the series include series star and producer Stefan Brogren, Eleanor Lindo, Phil Earnshaw, and Rt!.
Episode format[edit]
Each episode of Degrassi: Next Class is written following the same formula with three storylines (Plot A, Plot B and Plot C). The problems and issues presented in the episode are not always resolved by the end of the episode, and are carried over throughout the season, creating a mini-arc. With "Next Class", some episodes have the plots follow a common theme. This concept was featured in Degrassi Junior High and Degrassi High. Episode titles feature a "#" in the front of each episode title and occasionally refer to current social media trends.
Opening sequence[edit]
The opening sequence of "Next Class" returned to the longer openings that was featured in the first twelve seasons of "The Next Generation" but was cut to 31 seconds. The opening comes after a two- to three-minute cold open but does not follow the characters around the school. Instead, a montage of videos and pictures from the characters social media accounts cycle across the screen. Like the final two seasons of "Degrassi", instead of listing every ensemble actor in the opening, episodes only credit the regular actors appearing in that episode. The theme music, "Whatever It Takes", was composed by Jim McGrath, with lyrics written by Jody Colero and Stephen Stohn. The lyrics for the theme music for the first four seasons of "Next Class" were the same as theme music for "The Next Generation." [23] The "Next Class" opening sequence featured a rearranged version of "Whatever It Takes" composed by Jody Colero, Jim McGrath, Stephen Stohn, Rob Wells, and Shobha. Shobha also recorded the song.[24]
Filming locations[edit]
The Degrassi universe is set on De Grassi Street in Toronto, Ontario. The four previous series were filmed on and near that street.[25] However, Degrassi is currently filmed at Epitome Pictures' four soundstages and backlot located at the company's 100,000-square-foot (9,300 m2) production studios in Toronto.[26] The facade of Degrassi Community School is the exterior of Studio C, and uses the same colours and glass pattern as Centennial College, which was used to depict the school during Degrassi High.
The area in front of this facade features a "hoarding area" where students gather, a street, and a bus stop across the road.[26] The studio's backlot is used for exterior shots of the characters' houses, which is one unit dressed differently for each house, and The Dot Grill.[27] The building for The Dot is the only one on the backlot large enough to allow filming inside; scenes taking places inside the school and house interiors are filmed on one of four sound stages.[26]
Studio A contains sets for the school's hallways, washrooms, cafeteria and classrooms.[26] The hallways are stenciled with phrases such as "the perfect human being is all human", which were found at the Etobicoke School for the Arts, one of the many schools that set designers used during their original research. The washroom set is used for the girls' and boys' room; urinals are installed and removed as needed."[28] It is also used as the studio's cafeteria where the cast and crew eat.[28]
In addition to being used as the exterior of the school, Studio C holds sets for the school's entrance foyer, the gymnasium, the media lab and a hallway with lockers.[26] As the franchise progressed and the budget increased, a stairway and balcony was installed in the foyer in an attempt to get characters off the floor and not all appear in the same geometric plane. For the first few seasons of The Next Generation, the gym floor was made of real wooden floorboards; due to warping, it was replaced by concrete painted to look like wood.[29]
Studio B contains the sets for the characters' houses. The fourth studio, Studio D, houses all the production offices, dressing rooms, and make-up and hair departments.
For the new series, Next Class, the interior of the school set saw a major facelift. New doors were added for all classrooms, room numbers were placed on doors, classrooms were remodeled to be more modern which included new "smart-boards" and high-definition television sets (also placed throughout the hallways, cafeteria and gym), and the lockers were repainted for a more "retro" look. Several new sets were also added which include: a new student lounge room, an area called the "conversation pit", a remodeled classroom for Digital arts, and a restaurant called "Lola's Cantina".[30][31]
Broadcast[edit]
In Canada, the series premiered on January 4, 2016, on Family’s new teen programing block, F2N. In the United States (and internationally), first-run episodes began streaming internationally on Netflix on January 15, 2016 (excluding Canada, Australia and France). Episodes will be available on Netflix in Canada, Australia and France following the conclusion of the first season.[32][33] Season two premiered on the Family Channel on July 19, 2016 and on Netflix on July 22, 2016.
In Australia, the series premiered on ABC3 on May 16, 2016.[34] The second season immediately followed the first season on ABC3 in Australia on May 30.[35] On January 6, 2017, Netflix added seasons 1–3 to the Australian catalogue. Season 3 began streaming online on Netflix before its debut on ABC3, starting April 22, 2017.
Notes[edit]
^ Jump up to: a b "Family Channel's new teen block F2N launches January 4 with the premiere of Degrassi: Next... - TORONTO, Nov. 30, 2015". Newswire.ca. Retrieved 2015-12-05.
Jump up ^ "Degrassi: Next Class - TV Show, Episode Guide & Schedule". TWC Central.
Jump up ^ "TV Listings Grid, TV Guide and TV Schedule, Where to Watch TV Shows - Screener". tvlistings.zap2it.com.
Jump up ^ "Degrassi: Next Class Season 4 Release Date and Trailers". denofgeek.com. Retrieved 30 June 2017.
Jump up ^ "Degrassiland - Canadaland". Canadalandshow.com. 2016-11-23. Retrieved 2017-01-30.
Jump up ^ "Archived copy". Archived from the original on December 5, 2016. Retrieved December 2, 2016.
Jump up ^ Peltz, Jonathan (2015-08-03). "High School Never Ends: An Interview with the Creators of 'Degrassi' | VICE | United States". VICE. Retrieved 2015-08-11.
Jump up ^ "REPORT: Degrassi Next Class Debuts January 15th | Kary's Degrassi Blog". Degrassiblog.com. 2015-11-22. Retrieved 2015-12-05.
Jump up ^ "F2N". F2n.ca. Retrieved 2015-12-05. [permanent dead link]
Jump up ^ Swift, Andy (2016-04-11). "'Degrassi: Next Class' Season 2 Premiere Date — Renewed By Netflix". TVLine.com. Retrieved 2016-05-27.
Jump up ^ Yan Moore; Linda Schuyler; Kit Hood (2016-01-15). "Watch Degrassi: Next Class Online". Netflix.com. Retrieved 2017-01-26.
Jump up ^ "TV Listings Grid, TV Guide and TV Schedule, Where to Watch TV Shows - Screener". Tvlistings.zap2it.com. Retrieved 2017-01-26.
Jump up ^ "Degrassi: Next Class Season 4 Release Date and Trailers". denofgeek.com. Retrieved June 30, 2017.
Jump up ^ "Degrassi: Next Class Season 4 Release Date and Trailers". Den of Geek. Retrieved 2017-07-11.
Jump up ^ "Amir Bageria". Twitter. Retrieved May 30, 2016.
Jump up ^ "Audition Info For Degrassi: Next Class Season 3". Degrassiblog.com. March 21, 2016. Retrieved May 30, 2016.
Jump up ^ "Exclusive Tour of the Degrassi Set, (Epitome Picture) At DHX Media". YouTube. 2016-10-21. Retrieved 2017-01-30.
Jump up ^ "Instagram". Instagram. 2016-08-19. Retrieved 2017-01-30.
Jump up ^ "'Degrassi: Next Class': Get a first look at the big reunion". Ew.com. Retrieved May 30, 2016.
Jump up ^ "Degrassi on Twitter: "They're back. Feel free to fan out. And Keenan Neal as Kizzie #DegrassiReunion "". Twitter. 2016-07-15. Retrieved 2016-08-19.
Jump up ^ Peltz, Jonathan (2015-08-03). "High School Never Ends: An Interview with the Creators of 'Degrassi' | VICE | United States". VICE. Retrieved 2015-08-11.
Jump up ^ Chan, Melissa. "Watch the New Trailer for 'Degrassi: Next Class'". Time. Retrieved 2017-09-21.
Jump up ^ LaScala, Marisa. "The 'Degrassi: Next Class' Theme Song Updates The Classic "Whatever It Takes" For A New Generation". Retrieved 2017-09-21.
Jump up ^ "Degrassi: Next Class Opening Sequence". YouTube. 2015-11-30. Retrieved 2016-01-31.
Jump up ^ Ellis 2005, pp. 106–111
^ Jump up to: a b c d e "Epitome Pictures" (Flash (User must select the "Studios" link)). Epitome Pictures. Retrieved October 21, 2007.
Jump up ^ Ellis 2005, pp. 116–117
^ Jump up to: a b Ellis 2005, p. 115
Jump up ^ Ellis 2005, pp. 112–114
Jump up ^ "Inside The Studio with Ana Golja and Dante Scott - Degrassi: Next Class". YouTube. 2016-01-15. Retrieved 2016-01-31.
Jump up ^ "Behind-The-Scenes Of Degrassi: Next Class With Ana Golja & Sara Waisglass". YouTube. 2017-01-08. Retrieved 2017-01-30.
Jump up ^ "DHX Media buys Degrassi TV studio". The Globe and Mail. Retrieved 9 June 2015.
Jump up ^ "Degrassi: Next Class to debut on Family Channel, Netflix". CBC News. June 9, 2015. Retrieved June 9, 2015.
Jump up ^ Knox, David (May 16, 2016). "Airdate: Degrassi: Next Class". TV Tonight. Retrieved May 16, 2016.
Jump up ^ "Degrassi: Next Class". Abc.net.au. Retrieved May 30, 2016.
References[edit]
Ellis, Kathryn (September 2005). "Degrassi: Generations - The Official 411". New York, New York: Pocket Books. ISBN 978-1-4165-1680-4.
External links[edit]
Wikiquote has quotations related to: Degrassi: The Next Generation
Wikimedia Commons has media related to Degrassi: The Next Generation.
Official MTV Canada website (Canada)
Official TeenNick website (United States)
Degrassi: The Next Generation on IMDb
[show]
v
t
e
Degrassi franchise
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Ida Makes a Movie
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Episodes
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