Premium
Kinetic Modeling of Intradialytic and Interdialytic pH Shifts During and After Acetate and Bicarbonate Hemodialysis
Author(s) -
Monti JeanPierre,
Sarrazin Marcel Y.,
Baz Mahmoud,
Murisasco Antoine,
Crevat Aimé D.,
Elsen Raymond
Publication year - 1990
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1990.tb02956.x
Subject(s) - bicarbonate , hemodialysis , chemistry , carbonic anhydrase , acidosis , metabolic acidosis , dialysis , hemoglobin , compartment (ship) , biochemistry , medicine , enzyme , organic chemistry , oceanography , geology
A kinetic model involving intraerythrocytic and whole blood H+ concentrations during and after bicarbonate and acetate hemodialysis is proposed to account for experimental data. A two‐compartment model appeared to be the simplest kinetic model to explain the decrease in proton concentration during bicarbonate hemodialysis and its increase between two dialysis sessions, whether acetate or bicarbonate. This model takes into account the hemoglobin buffer power and the cellular metabolic acidosis. During acetate hemodialysis, one must introduce a new compartment to explain the initial increase in H+ concentration in erythrocytes. This compartment, which generates protons, seems to correspond to the carbonic anhydrase cycle. The various parameters obtained show no significant variations between patients receiving bicarbonate hemodialysis. For acetate hemodialysis, the model describes equally well patients with a great initial increase in H+ concentration and those with a slight initial increase. The variations observed in the parameters are due mainly to the carbonic anhydrase compartment. It is suggested the magnitude of this initial increase and the degree of acetate intolerance are correlated.