Acid-base kinetics during hemodialysis using bicarbonate and lactate as dialysate buffer bases based on the H+ mobilization model

The International Journal of Artificial Organs
John K LeypoldtJacek Waniewski

Abstract

The H+ mobilization model has been recently reported to accurately describe intradialytic kinetics of plasma bicarbonate concentration; however, the ability of this model to predict changing bicarbonate kinetics after altering the hemodialysis treatment prescription is unclear. We considered the H+ mobilization model as a pseudo-one-compartment model and showed theoretically that it can be used to determine the acid generation (or production) rate for hemodialysis patients at steady state. It was then demonstrated how changes in predialytic, intradialytic, and immediate postdialytic plasma bicarbonate (or total carbon dioxide) concentrations can be calculated after altering the hemodialysis treatment prescription. Example calculations showed that the H+ mobilization model when considered as a pseudo-one-compartment model predicted increases or decreases in plasma total carbon dioxide concentrations throughout the entire treatment when the dialysate bicarbonate concentration is increased or decreased, respectively, during conventional thrice weekly hemodialysis treatments. It was further shown that this model allowed prediction of the change in plasma total carbon dioxide concentration after transfer of patients from conventiona...Continue Reading

References

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Related Concepts

Bicarbonates
Buffers
Carbon Dioxide
Dialysis Solutions
Hemodialysis
Lactates
Plasma
Generic Drugs
Therapeutic Mobilization
Amino Acids, Basic

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