Determinants of Hemodialysis Performance: Modeling Fluid and Solute Transport in Hollow-Fiber Dialyzers.
Determinants of Hemodialysis Performance: Modeling Fluid and Solute Transport in Hollow-Fiber Dialyzers.
复制标题
血液透析性能的决定因素：中空纤维透析器中液体和溶质传输的建模。
DOI：
10.1007/s40883-019-00135-0
复制
发表时间：
2021-09
影响因子：
2.6
通讯作者：
Wong JY
中科院分区：
文献类型：
--
作者：
Yu J;Chitalia VC;Akintewe OO;Edwards A;Wong JY
血液透析是终末期肾病患者的生命线，但影响血液透析器性能的参数仍不完全清楚。我们建立了中空纤维透析器内质量传递和溶质传递的计算模型，以更好地了解决定因素。该模型预测了给定几何特征、膜传输特性和入口条件下的流体速度、压力和溶质浓度分布。我们在标准临床实践的约束下，通过改变参数值，研究了转运和结构参数对尿毒症溶质清除的影响。通过与已发表的实验数据进行比较，验证了该模型的有效性。我们的结果表明，血液和透析液流量、纤维半径和长度以及净超滤率的变化可以显著改变溶质清除。我们的模型进一步表明，非反应溶质清除的主要决定因素是它们的扩散渗透性。蛋白质结合毒素的清除也很大程度上取决于血液中的红细胞压积和血浆蛋白浓度。该模型的结果可能有助于在临床实践中优化血液透析器的操作条件，以实现对致病尿毒症溶质的更好清除。美国有近50万名肾透析患者，其中很大一部分患者使用中空纤维透析器；然而，他们的表现还有很大的提高空间。为了解决这个问题，我们开发了一个计算模型来了解中空纤维透析器的传输特性及其对毒素清除的影响。这项研究的灵感来自于罗伯特·S·兰格在体外装置中固定化肝素酶领域的早期工作，我们继续将他作为翻译研究的灵感来源，用他的话说--“对提高生活质量产生积极影响”。
Hemodialysis constitutes the lifeline of patients with end stage renal disease, yet the parameters that affect hemodialyzer performance remain incompletely understood. We developed a computational model of mass transfer and solute transport in a hollow-fiber dialyzer to gain greater insight into the determinant factors. The model predicts fluid velocity, pressure, and solute concentration profiles for given geometric characteristics, membrane transport properties, and inlet conditions. We examined the impact of transport and structural parameters on uremic solute clearance by varying parameter values within the constraints of standard clinical practice. The model was validated by comparison with published experimental data. Our results suggest solute clearance can be significantly altered by changes in blood and dialysate flow rates, fiber radius and length, and net ultrafiltration rate. Our model further suggests that the main determinant of the clearance of unreactive solutes is their diffusive permeability. The clearance of protein-bound toxins is also strongly determined by blood hematocrit and plasma protein concentrations. Results from this model may serve to optimize hemodialyzer operating conditions in clinical practice to achieve better clearance of pathogenic uremic solutes. There are nearly 500,000 patients in the US on kidney dialysis, and a large percentage of these patients use hollow-fiber dialyzers; yet, there is much room for improvement of their performance. To address this issue, we developed a computational model to understand the transport properties of hollow-fiber dialyzers and their effects on clearance of toxins. This study is inspired by the early work of Robert S. Langer in the area of immobilized heparinase in extracorporeal devices, and we continue to look to him as an inspiration for translational research to – in his words – “make a positive impact to improve the quality of life”.
登录
查看更多内容
DOI：
10.1053/j.ajkd.2009.01.265
发表时间：
2009-06
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
通讯作者：
--
影响因子：
3.7
作者：
Eloot S;Schneditz D;Cornelis T;Van Biesen W;Glorieux G;Dhondt A;Kooman J;Vanholder R
通讯作者：
Vanholder R
影响因子：
4.6
作者：
Maheshwari V;Thijssen S;Tao X;Fuertinger D;Kappel F;Kotanko P
通讯作者：
Kotanko P
影响因子：
13.2
作者：
Daugirdas, John T.;Depner, Thomas A.;Weiner, Daniel E.
通讯作者：
Weiner, Daniel E.
影响因子：
9.5
作者：
Donato, Danilo;Boschetti-de-Fierro, Adriana;Segers, Patrick
通讯作者：
Segers, Patrick