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Hemodial Int. 2016 Apr;20(2):226-34. doi: 10.1111/hdi.12343. Epub 2015 Aug 5.

Calculation of the clearance requirements for the development of a hemodialysis-based wearable artificial kidney.

Kim DK1,2,3, Lee JC4,5,6, Lee H1, Joo KW1,2,3, Oh KH1,2, Kim YS1,2,3, Yoon HJ4,5,6, Kim HC4,5,6.

Author information

1
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
2
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
3
Kidney Research Institute, Medical Research Center, Seoul National University, Seoul, South Korea.
4
Department of Biomedical Engineering, Seoul National University Hospital, Seoul, South Korea.
5
Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea.
6
Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, South Korea.

Abstract

Wearable artificial kidney (WAK) has been considered an alternative to standard hemodialysis (HD) for many years. Although various novel WAK systems have been recently developed for use in clinical applications, the target performance or standard dose of dialysis has not yet been determined. To calculate the appropriate clearance for a HD-based WAK system for the treatment of patients with end-stage renal disease with various dialysis conditions, a classic variable-volume two-compartment kinetic model was used to simulate an anuric patient with variable target time-averaged creatinine concentration (TAC), daily water intake volume, daily dialysis pause time, and patient body weight. A 70-kg anuric patient with a HD-based WAK system operating for 24 h required dialysis clearances of creatinine of at least 100, 50, and 25 mL/min to achieve TACs of 1.0, 2.0, and 4.0 mg/dL, respectively. The daily water intake volume did not affect the clearance required for dialysis under various conditions. As the pause time per day for the dialysis increased, higher dialysis clearances were required to maintain the target TAC. The present study provided theoretical dialysis doses for an HD-based WAK system to achieve various target TACs through relevant mathematical kinetic modeling. The theoretical results may contribute to the determination of the technical specifications required for the development of a WAK system.

KEYWORDS:

Clearance; continuous dialysis; hemodialysis; kinetic model; wearable artificial kidney

PMID:
26245302
DOI:
10.1111/hdi.12343
[Indexed for MEDLINE]

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