A One-Dimensional Model of Simultaneous Hemodialysis and Ultrafiltration With Highly Permeable Membranes

Jaffrin, Michel Y.; Gupta, B. B.; Malbrancq, J.M.

doi:10.1115/1.3138290

Cited by 43 publications

(28 citation statements)

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“…In reality, ultrafiltra tion diminishes along the filter length due to the axial pressure drop in the blood compart ment. In view of the relatively small decrease in solute concentration in the blood com partment, this assumption has only a minor influence on calculated convective transport [4,9], For instance, in case of the average fall in transmembrane pressure gradient of 48% and the average fall in plasma solute concen tration of 16 %, it can be calculated that our model underestimates convective solute transport by less than 2 %. As the convective transport rate is usually small relative to the diffusive transport rate, also the influence on calculated Kd will be negligible.…”

Section: The Modelmentioning

confidence: 99%

“…equation 11) is justified. Furthermore, this same defi nition has been used in several previous model descriptions of hémodiafiltration [9,10,13].…”

Section: The Modelmentioning

confidence: 99%

“…The model developed by Jaffrin et al [9] is a description of hémodiafiltration. In that model, however, changes in blood and dialysate solute concentrations are not considered and, hence, that model does not provide a means to estimate the diffusive mass trans fer coefficient (Kd).…”

Section: The Modelmentioning

confidence: 99%

See 2 more Smart Citations

Solute Transport in Continuous Arteriovenous Hemodiafiltration: A New Mathematical Model Applied to Clinical Data

Vincent¹,

Ittersum²,

Akcahuseyin

et al. 1990

Blood Purif

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A mathematical model of continuous arteriovenous hemodiafiltration is presented, by which the diffusive mass transfer coefficient (K_d) for a solute may be calculated from blood, filtrate and dialysate flow rates and solute concentrations. The model was applied to clinical data obtained with 0.6-m² AN69 capillary dialyzers that had been used for up to 5 days. The diffusive mass transfer coefficient proved to depend on dialysate flow rate. Furthermore, it was related to the membrane index of ultrafiltration, as measured in the clinic, and to the filter resistance to blood flow. Measurement of these filter characteristics allowed a reasonable prediction of solute clearance.

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Section: The Modelmentioning

confidence: 99%

“…equation 11) is justified. Furthermore, this same defi nition has been used in several previous model descriptions of hémodiafiltration [9,10,13].…”

Section: The Modelmentioning

confidence: 99%

See 1 more Smart Citation

Solute Transport in Continuous Arteriovenous Hemodiafiltration: A New Mathematical Model Applied to Clinical Data

Vincent¹,

Ittersum²,

Akcahuseyin

et al. 1990

Blood Purif

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“…In terms of efficiency the behavior of solute clearances is unique in HDF, since the simultaneous occurrence of diffusive and convective clearances tends to cut down the powerful action of each process [9]. Such a phenomenon underlines the fact that the global efficiency of HDF may not be considered as the simple sum of diffusive and convective clearances.…”

Section: Introductionmentioning

confidence: 99%

On-Line Hemodiafiltration as Routine Treatment of End-Stage Renal Failure: Why Pre- or Mixed Dilution Mode Is Necessary in On-Line Hemodiafiltration Today?

et al. 2004

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Hemodiafiltration (HDF) is a well-recognized treatment modality that offers a way of optimizing renal replacement therapy efficacy of end-stage renal disease (ESRD) patients. On-line production of substitution fluid by the ‘cold sterilization’ process (ultrafiltration) gives access to an unlimited amount of sterile and non-pyrogenic IV grade solution. This advantageous low-cost solution may therefore be employed to develop various forms of high-flux HDF modalities (ol-HDF). High-flux post-dilutional HDF (post-HDF) has mainly been used in clinical practice since it offers the most efficient and best compromise between diffusive and convective clearances. Nowadays, the new targets in anemia correction have created hemorheological conditions that render high filtration rate more difficult to achieve and/or at the expense of higher transmembrane pressure. To overcome this new challenging condition and keeping the same concept, it has been proposed to develop alternative modalities with various sites of fluid substitution (predilution, mixed pre-post with various percentages) in HDF. In this presentation we discuss the benefits of using pre-HDF and show how to match performances with post-HDF. Potential advantages of new ol-HDF options (pre-, mixed and mid-dilution) that are advocated have to be demonstrated in clinical trials. On-line HDF is a multipurpose treatment method that is employed to improve care and outcomes of ESRD patients. Due to its versatility, ol-HDF should be considered as a technical platform permitting to personalize and tailor treatment to patients’ needs. The mode of substitution (post-, pre-, mixed or mid-dilution) should be established according to hemorheological conditions of the individual patient.

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“…However, the coexistence of convection and diffusion on the same membrane penalizes solute clearance and mass removal as well as limits the depurative potential of hémodiafil tration. In fact, the diffusive process reduces the solute concentration in the volume removed by convection, so that the total mass transfer of solutes does not result from the sum of the two independent processes [2][3][4]. More over, the use of a high ultrafiltration rate leads to protein deposits on the artificial membrane and to secondary membrane formation [5] which is responsible for the progressive decrease in the dialyzer's hydraulic perme ability, thus reducing mass transfer.…”

Section: Introductionmentioning

confidence: 99%

Paired Filtration Dialysis: Optimizing Depurative Efficiency with Separate Convection and Diffusion Processes

Zucchelli

Botella

Spongano

et al. 1990

Nephron

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To overcome reciprocal interaction between convection and diffusion occurring in hemodiafiltration, we separated the two processes in a new dialysis technique called paired filtration dialysis (PFD). In this technique, convection and diffusion take place separately on two capillary membranes: a polysulfone hemofilter and a hemophan dialyzer. The depurative effectiveness of PFD with respect to small (blood urea nitrogen, creatinine, uric acid, phosphate) and large (β₂-microglobulin) molecules was acutely assessed in 6 patients on maintenance acetate hemodialysis. Despite a 3-hour treatment time, a high mass removal of small and large solutes was found in PFD without high ultrafiltration rates or blood flows in excess of 300 ml/min. There was no significant difference in solute removal between the two different depurative sequences adopted in PFD, i.e., convection followed by diffusion or vice versa. A significant reduction in β₂-microglobulin serum levels was observed in both PFD modes. Twenty patients, on a 12-month period of 3-hour PFD treatment, maintained an unaltered metabolic, clinical, and acid-base status, and cardiovascular stability was not affected. PFD thus provides excellent depurative results, along with simple technical features that are particularly useful in treating patients with high depurative needs and yet are unable to tolerate high-flux techniques.

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A One-Dimensional Model of Simultaneous Hemodialysis and Ultrafiltration With Highly Permeable Membranes

Cited by 43 publications

References 0 publications

Solute Transport in Continuous Arteriovenous Hemodiafiltration: A New Mathematical Model Applied to Clinical Data

Solute Transport in Continuous Arteriovenous Hemodiafiltration: A New Mathematical Model Applied to Clinical Data

On-Line Hemodiafiltration as Routine Treatment of End-Stage Renal Failure: Why Pre- or Mixed Dilution Mode Is Necessary in On-Line Hemodiafiltration Today?

Paired Filtration Dialysis: Optimizing Depurative Efficiency with Separate Convection and Diffusion Processes

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