MATHEMATICAL MODELING OF HEMODIALYSIS AND MEASUREMENT OF BODY WATER

美国ESRD人群的发病率和死亡率高于 欧洲和亚洲的其他工业化国家是一个主题， 监管关注和正在进行的积极调查。 有证据 很大一部分，也许是大多数， 患者接受的治疗不足，这可能是导致 高死亡率。 接受血液透析的儿童也会遭受许多同样的痛苦， 成年患者的问题，但很少有调查针对 小儿透析患者。 已经开发了几个数学模型来描述这些事件 在血液透析治疗期间和之后发生， 准确有效清除治疗。 现有数据表明 该模型在测量透析输送时可能特别有用， 极端的身体大小，因此将是特别重要的小 孩子 然而，这些模型仅在成人中得到验证 血液透析患者，尚未在儿童中进行充分研究。 在本方案中，将进行血液透析的数学建模 在常规透析过程中的儿童。 此外，本研究还将获得有关人体水空间的规范性数据 （总身体水，细胞内水和细胞外水） 儿童慢性肾衰竭，以允许准确建模 透析期间的清除率。 儿童体内水空间数据 肾衰竭对于药代动力学应用也是重要的， 可以预测药物的分布和清除。

Excess morbidity and mortality in the US ESRD population compared to other industrialized nations in Europe and Asia is a subject of regulatory concern and active ongoing investigation. There is evidence that a large proportion, perhaps the majority, of American hemodialysis patients receive inadequate therapy and that this may be the cause of high mortality. Children on hemodialysis suffer many of the same problems of adult patients and yet few investigations have targeted pediatric dialysis patients. Several mathematical models have been developed to describe the events that occur during and after hemodialysis treatments and to measure accurately the effective clearance of treatments. Available data suggest that models may be especially useful in measuring dialysis delivery at extremes of body size, and thus would be particularly important in small children. However, these models have been validated only in adult hemodialysis patients and have not been adequately studied in children. In this protocol, mathematical modeling of hemodialysis will be performed in children during routine dialysis sessions. In addition, this study will obtain normative data on body water spaces (total body water, intracellular water, and extracellular water) in children with chronic kidney failure to allow accurate modeling of clearances during dialysis. Data on body water spaces in children with renal failure will also be important for pharmacokinetic applications to allow predictions of drug distribution and clearances.