PubMed Health⌕ Search

PubMed · 1787649

Sodium modeling in hemodiafiltration.

Abstract

A computer model was developed to simulate sodium and water kinetics during hemodiafiltration (HDF), acetate-free biofiltration (AFB) and hemodialysis (HD). Multiple regression analysis of the results of 3,240 simulated applications of the model (1,620 HDF, 1,080 AFB, 540 HD) showed that, during HDF and AFB, there is a close correlation (R2 = 0.92 and 0.91) between plasma water sodium concentration [( Na+P]) and a set of three variables: 1) the sodium gradient between plasma water and dialysate, 2) the sodium concentration of the substitution fluid and 3) ultrafiltration (UF) rate. With HD, a close correlation (R2 = 0.94) was found between changes in [Na+P] and combined changes in sodium gradient and the UF rate. On this basis, a regression equation was formulated for each procedure which allowed a reliable prediction of final [Na+P] to be made on the basis of knowledge of the imposed Na gradient, the programmed infusion (during HDF and AFB), and the UF rate. Clinical validation of the model was obtained in 12 patients: predicted final [Na+P] agreed well with the values measured by means of direct potentiometry (141.9 vs. 142.1 mEq/liter; P = NS), with a mean difference (-0.16 mEq/liter) and limits of agreement (+0.8 to -1.03 mEq/liter) fully acceptable for clinical purposes.(ABSTRACT TRUNCATED AT 250 WORDS)

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

L A Pedrini, R Ponti, P Faranna, G Cozzi, F Locatelli. 1991. Sodium modeling in hemodiafiltration.. https://doi.org/10.1038/ki.1991.241

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Decrease in extracellular collagen crosslinking after NMR magnetic field application in skin fibroblasts.

Although biological effects of electromagnetic fields were investigated intensively, there is still no agreement on the significance of their effects. The underlying mechanisms and therapeutic importance are still mostly unknown too. In this study, primary cultures of human dermal fibroblasts were exposed to magnetic field at nuclear magnetic resonance (NMR) conditions for in total 5 days and 4 h/day. Among the investigated parameters were: cell proliferation rate, cell morphology, total protein concentration as well as content of skin-specific collagen types I, III, IV. NMR exposure induced distinct changes both in cellular and extracellular components. The extracellular matrix (ECM) of NMR-exposed cells had less cross-linked collagen. In particular, the increase of collagen of the soluble fraction was at 17.2 +/- 2.9% for type I, 27.0 +/- 1.86% for type III, 17.3 +/- 1.46% for type IV (N = 6). In the absence of resonance frequency, the effects of magnetic field on ECM were less profound.

Body Water↗

Correlation between net water flux and absorptive clearance determined from in situ intestinal perfusion studies does not necessarily indicate a solvent drag effect.

Estimation of absorptive clearance (PeA) of drugs from in situ perfusion studies, based on the disappearance of drugs from the intestinal lumen, involves correcting outflow perfusate drug concentration with net water flux (Jw). However, as demonstrated through both theoretical derivations and simulations, the PeA estimated from a nonlinear equation approximates a linear relationship with Jw for a low permeability drug, regardless of whether or not Jw has a real effect on PeA. As such, a correlation between Jw and PeA is less meaningful as an indicator of a solvent drag effect. Moreover, from the linear relationship, the slope of the Jw-PeA correlation plot (defined as the sieving coefficient) equals the ratio of outflow versus inflow perfusate drug concentrations and can be greater than unity when more water than drug is absorbed during perfusion studies. The intercept of the correlation plot can be below zero if this occurs.

Body Water↗

Water imaging (hydrography) in the fetus: the value of a heavily T2-weighted sequence.

BACKGROUND: Since the development of fast imaging sequences, MR has proved to be a helpful tool in the evaluation of fetal pathology. Because of the high water content of fetal tissues and pathology, hydrography imaging (MR fetography) can provide additional diagnostic information. OBJECTIVE: To demonstrate the benefit of MR fetography in fetal imaging. MATERIALS AND METHODS: From 2004 to 2005, 126 fetal MR examinations were performed for evaluation of an abnormality depicted on an antenatal sonogram. Single-shot fast spin-echo MR imaging and MR fetography were performed through the area of fetal pathology. The two studies were retrospectively compared. RESULTS: The primary diagnosis was not changed with the addition of MR fetography. New findings, particularly in the kidneys and spine, were identified in 9% of the patients. When fetal pathology was of high water content (80% patients), the MR fetography imaging increased diagnostic confidence. In 11% of the patients, those with cardiovascular or low water pathology, the MR fetography was not beneficial. CONCLUSION: The mainstay of fetal imaging is currently the HASTE and SSFSE sequences. However, MR fetography is an excellent adjunct that highlights fetal pathology by reinforcing the diagnosis, identifying additional findings, and providing high-contrast high-resolution images that are helpful when counseling clinicians and patients.

Body Water↗