Simulating the effect of exercise on urea clearance in hemodialysis.

Journal of the American Society of Nephrology : JASN
S W SmyeE Will

Abstract

A two-compartment model of urea kinetics during hemodialysis is used to predict the effect of exercise on hemodialysis dose. It is assumed that the two compartments represent tissues that are perfused by low and high blood flows (initially 1.1 L/min and 3.8 L/min). The effect of changing the distribution of flows between the compartments, emulating the effect of exercise, is simulated using the model equations for a range of dialyzer clearances. Compartmental volumes are assumed constant (33.4 L and 8.6 L for low- and high-flow compartments, respectively). The analysis identifies muscle perfusion as a rate-limiting factor during the later stages of hemodialysis and illustrates the benefit of exercise during this phase in increasing dialysis efficiency. The model suggests that the postdialysis rebound in the blood urea concentration is eliminated by increasing flow to the low-flow compartment from 1.1 L/min to 7.1 L/min and sustaining this for at least 30 min of a 150-min dialysis session, independent of the dialyzer clearance. Additional exercise will not increase the dialysis dose. Experimental studies are required to confirm the analysis.

Citations

Aug 8, 2001·Seminars in Dialysis·D Schneditz, J T Daugirdas
Oct 12, 2002·Medical Engineering & Physics·Stephen W Smye, Richard H Clayton
Aug 28, 2003·Artificial Organs·Emiliano Staffolani, Giorgio Splendiani
Jun 13, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Markus FeldkötterBernd Hoppe
Feb 13, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Daniel SchneditzJohn T Daugirdas
Aug 31, 2011·Annals of Biomedical Engineering·Vaibhav MaheshwariGade P Rangaiah
Oct 7, 2011·The Cochrane Database of Systematic Reviews·Susanne Heiwe, Stefan H Jacobson

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