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Comparison of two single-solute models of potassium kinetics during hemodialysis
Ist Teil von
Biocybernetics and biomedical engineering, 2020-07, Vol.40 (3), p.938-949
Ort / Verlag
Elsevier B.V
Erscheinungsjahr
2020
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Optimal potassium removal in hemodialysis (HD) is an important but difficult to achieve goal, influenced by numerous factors. Two types of single-solute mathematical models have been previously proposed to assess potassium kinetics in HD: pseudo-one compartment (p1) and two-compartment models (2c). We compared these two models in simulating potassium kinetics during HD sessions with different treatment settings.
After estimation of unknown parameters via fitting to clinical data during 4h sessions with a dialysate potassium of 2.6±0.6mmol/L, the models were used to simulate 4 HD sessions for each patient, resulting from the combination of session length (4h vs. 8h) and potassium dialysate concentration (2.6 vs. 0mmol/L).
The simulated potassium concentration profiles were similar under different treatment conditions, and predicted potassium removal during the treatments was 77±24mmol with the standard settings; both increases in session length and potassium dialysate to plasma concentration gradient resulted in a significant increase in potassium removed. Both models indicated similar minimum values of dialysate potassium concentration required to avoid post-HD hypokalemia: 1.18±0.66mmol/L for 4h HD and 1.71±0.52mmol/L for 8h HD.
The models described similar kinetics for potassium during different combinations of treatment settings. Total removal of potassium and minimum dialysate concentration to avoid post-HD hypokalemia, were predicted without significant differences by both models. Although no model has a clear advantage in terms of describing clinical data, our analyses suggest that 2c might offer a better trade-off between physiological accuracy and overparametrization.