1. A physiologically based model of vascular refilling during ultrafiltration in hemodialysis.
- Author
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de los Reyes V AA, Fuertinger DH, Kappel F, Meyring-Wösten A, Thijssen S, and Kotanko P
- Subjects
- Algorithms, Hematocrit, Humans, Kidney Failure, Chronic metabolism, Kidney Failure, Chronic physiopathology, Kidney Failure, Chronic therapy, Models, Theoretical, Time Factors, Ultrafiltration, Blood Volume physiology, Body Fluids metabolism, Dialysis Solutions metabolism, Renal Dialysis
- Abstract
An assessment of fluid status can be obtained by monitoring relative blood volume (RBV) during hemodialysis (HD) treatment. The dynamics of RBV is determined by fluid removal from the intravascular compartment by ultrafiltration (UF) and vascular refill from the interstitium. To characterize this dynamics, a two-compartment model describing the short-term dynamics of vascular refilling and UF is developed. Fluid movement between the compartments is governed by lymphatic and microvascular fluid shifts. Further, protein flux is described by convection, diffusion and the lymphatic protein flux. Patient specific parameters are identified based on hematocrit (Hct) measurements by the Crit-Line monitor (CLM). Different measurement frequencies and UF profiles are compared to determine data fidelity and influence on the quality of parameter estimates. This relevant information can be used to assess the (patho)physiological status of hemodialysis patients and could aid in individualizing therapy., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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