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Titolo: Analysis of urea nitrogen and creatinine kinetics in hemodialysis: Comparison of a variablevolume twocompartment model with a regional blood flow model and investigation of an appropriate solute kinetics model for clinicalapplication
Autore: Yamada, T; Hiraga, S; Akiba, T; Marumo, F;
 Indirizzi:
 Shakai Hoken Mishima Hosp, Dept Internal Med, Mishima, Shizuoka 411, JapanShakai Hoken Mishima Hosp Mishima Shizuoka Japan 411 Shizuoka 411, Japan
 Titolo Testata:
 BLOOD PURIFICATION
fascicolo: 1,
volume: 18,
anno: 2000,
pagine: 18  29
 SICI:
 02535068(2000)18:1<18:AOUNAC>2.0.ZU;2W
 Fonte:
 ISI
 Lingua:
 ENG
 Soggetto:
 TOTALBODY WATER; CARDIOPULMONARY RECIRCULATION; 2COMPARTMENT MODEL; DIALYSIS; EFFICIENCY; TRANSPORT; KT/V;
 Keywords:
 hemodialysis; solute kinetics; dialysis dose; urea nitrogen; creatinine; variablevolume twocompartment model regional blood flow model; blood recirculation; solute disequilibrium;
 Tipo documento:
 Article
 Natura:
 Periodico
 Settore Disciplinare:
 Clinical Medicine
 Citazioni:
 31
 Recensione:
 Indirizzi per estratti:
 Indirizzo: Yamada, T Shakai Hoken Mishima Hosp, Dept Internal Med, 209 Minamihon Cho, Mishima,Shizuoka 411, Japan Shakai Hoken Mishima Hosp 209 Minamihon Cho Mishima Shizuoka Japan 411



 Citazione:
 T. Yamada et al., "Analysis of urea nitrogen and creatinine kinetics in hemodialysis: Comparison of a variablevolume twocompartment model with a regional blood flow model and investigation of an appropriate solute kinetics model for clinicalapplication", BLOOD PURIF, 18(1), 2000, pp. 1829
Abstract
To investigate an appropriate solute kinetics model for clinical application, we analyzed urea nitrogen (UN) and creatinine (Cr) kinetics by a variablevolume twocompartmental model (2CM) and a regional blood flow model(RBF) in 44 hemodialysis patients with varying proportions of first compartmental volume and regional volume (p(1)). Solute kinetics could not be solved in some of the patients with higher pi values, and there were more solution failures by the RBF than by the 2CM. The solute generation rate (g) and solute distribution volume in the dry state (VD) increased with increases in p(1) in both models, but there were some differences between the two models. When g was normalized by VD, it became relatively constant, irrespectiveof the p(1) value or model used (0.133 +/ 0.029 mg/min/l by the 2CM and 0.132 +/ 0.029 mg/min/l by the RBF for UN; 0.0200 +/ 0.0049 mg/min/l by the 2CM and 0.0198 +/ 0.0048 mg/min/l by the RBF for Cr). The intercompartmental mass transfer coefficient (Kc; liters/min) calculated by the 2CM decreased as pi increased (Kc = 1.77 . p(1) + 1.16, p < 0.0001, R = 0.999 forUN; Kc = 0.847 . p(1) + 0.556, p < 0.0001, R = 1.000 for Cr). The systemic blood flow (Q(sys); liters/min) calculated by the RBF also decreased as pi increased (Q(sys) = 11.1 . p(1) + 6.21, p < 0.0005, R = 1.000 for UN; Q(sys) = 5.22 . p(1) + 2.90, p<0.001, R = 0.999 for Cr). Since the RBF morefrequently failed to solve the solute kinetics and since there was a difference in its Q(sys) values for UN and Cr, the 2CM was considered to be a superior model. When p(1) was extremely low, the 2CM could be transformed into a modified variablevolume onecompartment model (1CM) which presented a similar g/VD (0.133 + 0.029 for UN; 0.0200 +/ 0.0048 for Cr). This modified 1CM was considered to satisfy appropriate conditions for clinical application, since it is simpler than the 2CM and provides useful information on the dialysis dose. Copyright (C) 2000 S. Karger AG,Basel.
ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 00:02:52