Kinetic Analysis of Daily Hemofiltration
Abstract:Daily hemofiltration (D-HF) is a new treatment modality that shows unique solute removal characteristics and possibly provides high quality of life for patients with end-stage renal disease. Objective:
To evaluate solute-removal characteristics of D-HF by kinetic modeling analysis. Methods:
Five HD patients with normal 4 h × 3 times/week were switched to D-HF (2 h × 6 times/week). Ultrafiltration rates (QF) or small solute clearances were approximately 100 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 β2-microglobulin (β2-MG) decreased after switching from normal HD to D-HF (Figure 1). Predicted solute concentrations for UN as well as β2-MG correlated well with the clinical results. The model predicted that QF = 140 mL/min may be required for time-averaged concentration (TAC) of UN to be unchanged. The model also predicted that the 7-times/week D-HF may not increase the TAC of UN very much even after switching from normal HD to D-HF. Conclusion:
D-HF is suitable for removing larger solutes but may not be good enough for removing small solutes. A 7-day treatment (7 times/week) may greatly improve the solute removal capacity of the so-called daily treatment (6 times/week) not only for larger solutes but also for small solutes.
Document Type: Research Article
Publication date: January 1, 2004