SummaryBackground and objectives The kinetics of plasma phosphorus (inorganic phosphorus or phosphate) during hemodialysis treatments cannot be explained by conventional one-or two-compartment models; previous approaches have been limited by assuming that the distribution of phosphorus is confined to classical intracellular and extracellular fluid compartments. In this study a novel pseudo one-compartment model, including phosphorus mobilization from a large second compartment, was proposed and evaluated.Design, setting, participants, & measurements Clinical data were obtained during a crossover study where 22 chronic hemodialysis patients underwent both short (2-hour) and conventional (4-hour) hemodialysis sessions. The model estimated two patient-specific parameters, phosphorus mobilization clearance and phosphorus central distribution volume, by fitting frequent intradialytic and postdialytic plasma phosphorus concentrations using nonlinear regression.Results Phosphorus mobilization clearances varied among patients (45 to 208 ml/min), but estimates during short (98 Ϯ 44 ml/min, mean Ϯ SD) and conventional (99 Ϯ 47 ml/min) sessions were not different (P ϭ 0.74) and correlated with each other (concordance correlation coefficient c of 0.85). Phosphorus central distribution volumes for each patient (short: 11.0 Ϯ 4.2 L and conventional: 11.9 Ϯ 3.8 L) were also correlated ( c of 0.45). ConclusionsThe reproducibility of patient-specific parameters during short and conventional hemodialysis treatments suggests that a pseudo one-compartment model is robust and can describe plasma phosphorus kinetics under conditions of clinical interest.

The stability of wavy supercritical cylindrical Couette flow has been studied extensively, but few measurements of the velocity field in flow have been made. Particle image velocimetry was used to measure the azimuthal and radial velocities in latitudinal planes perpendicular to the axis of rotation for wavy cylindrical Couette flow in the annulus between a rotating inner cylinder and a fixed outer cylinder. These measurements were matched to previous measurements of the axial and radial velocity measured in several meridional planes resulting in an experimentally measured, time-resolved, three-dimensional, three-component velocity field for wavy cylindrical Couette flow. Using this complete velocity field it is possible to evaluate details of the flow field. The vortical motion transports azimuthal momentum radially while the axial exchange of fluid between vortices in wavy flow transports azimuthal momentum axially. As the Reynolds number increases, these effects strengthen. Streams of net axial flow stretch axially along the length of the annulus and wind around the vortices from the inner cylinder to the outer cylinder and back while also winding azimuthally in the annulus. The azimuthal velocity measured at the center of a vortex is similar to the azimuthal wave speed. Measurements of the azimuthal velocity in cylindrical surfaces concentric with the axis of rotation suggest that the origin of the waviness is related to a jet-like azimuthal velocity profile rather than the radial outflow jet. Near both cylinder walls, the shear stress is quite large, decreasing to near zero at the middle of the annular gap.

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Our recent work proposed a pseudo one-compartment model for describing intradialysis and postdialysis rebound kinetics of phosphorus. In this model, phosphorus is removed directly from a central distribution volume with the rate of phosphorus mobilization from a second, very large compartment proportional to the phosphorus mobilization clearance. Here, we evaluated factors of phosphorus mobilization clearance and postdialysis central distribution volume from 774 patients in the HEMO Study. Phosphorus mobilization clearance and postdialysis central distribution volume were 87 (65, 116) ml/min, median (interquartile range), and 9.4 (7.2, 12.0) liter, respectively. The phosphorus mobilization clearance was significantly higher for male patients than for female patients. Both the phosphorus mobilization clearance and the postdialysis central distribution volume were significantly associated with postdialysis body weight but negatively with the predialysis serum phosphorus concentration. The postdialysis central distribution volume was also significantly associated with age. Overall, the postdialysis central distribution volume was 13.6% of the postdialysis body weight. Thus, the phosphorus mobilization clearance during hemodialysis is higher when predialysis serum phosphorus concentration is low and higher in male patients than in female patients. The central distribution volume of phosphorus is a space approximating the extracellular fluid volume.

For frequent dialysis schedules, the urea generation factor (GFAC) of one commonly used Kt/V prediction equation should be adjusted based on length in days of the PIDI and number of treatments per week.