Kinetic modeling of continuous flow peritoneal dialysis
Kinetic modeling of continuous flow peritoneal dialysis
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DOI：
10.1046/j.1525-139x.2001.00096.x
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发表时间：
2001-09-01
影响因子：
1.6
通讯作者：
Gotch, FA
中科院分区：
文献类型：
--
作者：
Gotch, FA
已推导出动力学模型，用于分析新鲜腹膜透析液的连续单程流动和腹膜透析液通过外部透析器再循环的连续流动对腹膜尿素清除率（K-p）的影响。模型的广义解表明，两者都预测Kp是腹膜传质系数（MTC）和外部透析器透析率（D）的明确函数，而MTC是透析液流量和分布的函数。因此，模型应该是有用的，以指导研究，以优化CFPD。对报告的体内数据的分析表明，透析液流速和D均在200 ml/min范围内时，可实现60-70 ml/min的MTC水平和50 ml/min的K-p水平。如果模型预测在体内得到验证，每周6晚8小时过夜CFPD可以为平均大小的无肾患者提供3.2的每周stdKt/V，这与每日血液透析具有竞争力。超滤的动力学建模表明，使用1.0-1.25%葡萄糖透析液应实现0.2-03 L/hr的超滤速率。该模型显示，与具有相同液体清除量的CAPD相比，葡萄糖吸收的平均速率理论上可以降低33%。
Kinetic models have been derived for analysis of the effects on peritoneal urea clearance (K-p) of continuous single-pass flow of fresh peritoneal dialysate and continuous flow of peritoneal dialysate recirculating through an external dialyzer. Generalized solution of the models shows that both predict Kp to be a well-defined function of the peritoneal mass transfer coefficient (MTC) and the dialysance (D) of the external dialyzer, while the MTC is a function of the rate and distribution of dialysate flow. Thus the models should be useful to guide studies to optimize CFPD. Analysis of reported in vivo data indicate that with dialysate flow rate and D both in the range of 200 ml/min, MTC levels of 60-70 ml/min and K-p levels of 50 ml/min can be achieved. If the model predictions are verified in vivo, 8-hour overnight CFPD 6 nights/week could provide the average-size anephric patient a weekly stdKt/V of 3.2 which is competitive with daily hemodialysis. Kinetic modeling of ultrafiltration indicated ultrafiltration rates 0.2-03 L/hr should be achieved with 1.0-1.25% dextrose dialysate. The model shows average rates of glucose absorption can theoretically be reduced by 33% compared to CAPD with the same amount of fluid removal.