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Kinetic analysis of daily hemofiltration
Author(s) -
Yamashita Akihiro C,
Kawanishi Hideki
Publication year - 2004
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2004.80405.x
Subject(s) - hemodialysis , hemofiltration , ultrafiltration (renal) , medicine , urea , urology , kinetic energy , chemistry , chromatography , biochemistry , physics , quantum mechanics
Background: Daily hemofiltration (D‐HF) is a new treatment modality that shows unique solute removal characteristics and possibly provides a high quality of life for patients with end‐stage renal disease. We evaluated solute removal characteristics of D‐HF for five patients by kinetic modeling analysis. Methods: Five patients treated with normal 3 × 4 hr/week hemodialysis (HD) were switched to D‐HF (6 × 2 hr/week). Ultrafiltration rates (Q F ) or small‐solute clearances ranged from 63 to 106 mL/min. All the necessary kinetic parameters were determined from patients' physical data and HD portion of the clinical measurements. The two‐compartment kinetic model predicted the concentration changes after switching from normal HD to D‐HF. Results: Concentrations of small solutes such as urea nitrogen (UN) increased, whereas that of β 2 ‐microglobulin (β 2 ‐MG) decreased after switching from normal HD to D‐HF in all five patients. Predicted solute concentrations and clinical measurements for UN and β 2 ‐MG were in good agreement with mean error less than 10%. The model predicted that Q F = 155 mL/min may be necessary for time‐averaged concentration (TAC) of UN to be unchanged. The model also predicted that the 7 times/week D‐HF should not increase the pretreatment concentration of UN, expecting even much lower β 2 ‐MG concentration after switching from normal HD to D‐HF. Conclusion: D‐HF is superior to normal HD for removing larger solutes but may increase the TAC of small solutes. Seven‐day (7 times/week) D‐HF may improve the solute removal capacity of small solutes.