Modeling acid-base transport in hemodialyzers

Pietribiasi, Mauro; Leypoldt, John K.

doi:10.1016/j.bbe.2021.07.006

Cited by 2 publications

(3 citation statements)

References 41 publications

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“…analyzed. The interpretation of our estimated values of the dialysances of bicarbonate and CO 2 is, however, complicated by the interconversion of the two species, as already emphasized by several authors [33,39,44]. Several examples of this problem can be found in the literature.…”

Section: Plos Onementioning

confidence: 66%

“…Conversely, existing models applied specifically to the study of HD tend to neglect important mechanisms such as intracellular and non-bicarbonate buffers and respiratory regulation [19,26]. Most models neglect the transport of dissolved CO 2 from dialysis fluid, whose importance we discussed in a recent paper [39], and whose tangible impact has been revealed by symptoms such as HD-driven intra-dialytic acidosis [18,40]. Furthermore, the presence of intracellular buffers, and transport of mobile buffers such as bicarbonate between intracellular and extracellular fluids directly affects the acid-base equilibrium and should be taken into account in a mathematical description of these phenomena [41].…”

Section: Plos Onementioning

confidence: 99%

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Mathematical modelling of bicarbonate supplementation and acid-base chemistry in kidney failure patients on hemodialysis

Pietribiasi

Waniewski²,

Leypoldt³

2023

PLoS ONE

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Acid-base regulation by the kidneys is largely missing in end-stage renal disease patients undergoing hemodialysis (HD). Bicarbonate is added to the dialysis fluid during HD to replenish the buffers in the body and neutralize interdialytic acid accumulation. Predicting HD outcomes with mathematical models can help select the optimal patient-specific dialysate composition, but the kinetics of bicarbonate are difficult to quantify, because of the many factors involved in the regulation of the bicarbonate buffer in bodily fluids. We implemented a mathematical model of dissolved CO2 and bicarbonate transport that describes the changes in acid-base equilibrium induced by HD to assess the kinetics of bicarbonate, dissolved CO2, and other buffers not only in plasma but also in erythrocytes, interstitial fluid, and tissue cells; the model also includes respiratory control over the partial pressures of CO2 and oxygen. Clinical data were used to fit the model and identify missing parameters used in theoretical simulations. Our results demonstrate the feasibility of the model in describing the changes to acid-base homeostasis typical of HD, and highlight the importance of respiratory regulation during HD.

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Section: Plos Onementioning

confidence: 66%

Section: Plos Onementioning

confidence: 99%

Mathematical modelling of bicarbonate supplementation and acid-base chemistry in kidney failure patients on hemodialysis

Pietribiasi

Waniewski²,

Leypoldt³

2023

PLoS ONE

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“…Pietribiasi and coworkers have developed an analytic tool which allows for quantitation of each of these two sources of bicarbonate entry 16 . Not surprisingly, the dialysance of CO2 is much higher than that of ionic bicarbonate, and the two dialysances together actually exceed blood flow rate.…”

Section: Bicarbonate Dialysancementioning

confidence: 99%