Adequacy indices for dialysis in acute renal failure: kinetic modeling

Artificial Organs
Malgorzata DebowskaJacek Waniewski

Abstract

Many aspects of the management of renal replacement therapy in acute renal failure (ARF), including the appropriate assessment of dialysis adequacy, remain unresolved, because ARF patients often are not in a metabolic steady state. The aim of this study was to evaluate a system of adequacy indices for dialysis in ARF patients using urea and creatinine kinetic modeling. Kinetic modeling was performed for two different fictitious patients (A and B) with characteristics described by the average parameters for two patient groups and for two blood purification treatments: sustained low efficiency daily dialysis (SLEDD) in Patient A and continuous venovenous hemofiltration (CVVH) in Patient B, based on data from a clinical report. Urea and creatinine generation rates were estimated according to the clinical data on the solute concentrations in blood. Then, using estimated generation rates, two hypothetical treatments were simulated, CVVH in Patient A and SLEDD in Patient B. KT/V, fractional solute removal (FSR) and equivalent renal clearance (EKR) were calculated according to the definitions developed for metabolically unstable patients. CVVH appeared as being more effective than SLEDD because KT/V, FSR, and EKR were higher for CVVH ...Continue Reading

References

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Citations

Aug 31, 2011·Annals of Biomedical Engineering·Vaibhav MaheshwariGade P Rangaiah
Mar 16, 2011·Artificial Organs·Paul S Malchesky
Feb 4, 2012·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Ramón PaniaguaJacek Waniewski
Jan 22, 2011·The Veterinary Clinics of North America. Small Animal Practice·Larry D Cowgill
May 23, 2015·Artificial Organs·Malgorzata DebowskaWojciech Zaluska
Aug 21, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Malgorzata DebowskaJacek Waniewski
Dec 7, 2013·Computational and Mathematical Methods in Medicine·Przemysław Korohoda, Daniel Schneditz
Feb 6, 2014·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Malgorzata DebowskaJacek Waniewski
Dec 11, 2013·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Jacek WaniewskiBengt Lindholm

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