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Clin J Am Soc Nephrol. 2011 Dec;6(12):2854-60. doi: 10.2215/CJN.03860411. Epub 2011 Oct 27.

Kinetic model of phosphorus mobilization during and after short and conventional hemodialysis.

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  • 1Renal (MedicalProducts), Baxter Healthcare Corporation, McGaw Park, Illinois, USA.

Abstract

BACKGROUND 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 ± 44 ml/min, mean ± SD) and conventional (99 ± 47 ml/min) sessions were not different (P = 0.74) and correlated with each other (concordance correlation coefficient ρ(c) of 0.85). Phosphorus central distribution volumes for each patient (short: 11.0 ± 4.2 L and conventional: 11.9 ± 3.8 L) were also correlated (ρ(c) of 0.45).

CONCLUSIONS:

The 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.

PMID:
22034502
[PubMed - indexed for MEDLINE]
PMCID:
PMC3255375
Free PMC Article
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