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Hemofiltration pp 129-145 | Cite as

Quantitation and Prescription of Therapy

  • L. W. Henderson
  • J. K. Leypoldt
Chapter

Abstract

Since the inception of artificial kidney treatment, the renal clinician/researcher has been faced with the need to determine an adequate amount of therapy for the patient. As the artificial kidney attempts to replace the excretory function of the native kidney, determination of solute removal rates by the artificial kidney provides an important element necessary for quantitation of therapy. The classic work of Wolf et al. [1], who introduced the term dialysance to describe solute transport by hemodialyzers in analogy to renal clearance as defined by Van Slyke[2], was a major contribution and facilitated comparison of solute removal by the artificial kidney with that of the native kidney. Additional studies [3–5] provided the functional dependence of solute removal by the artificial kidney on clinical operating conditions, such as blood flow rate, dialyzer flow rate, membrane area, and membranes with different permeability spectra. While such studies contributed materially toward greater understanding of the impact of these variables on solute removal by the artificial kidney, they helped little, in the absence of good quality clinical correlations, to decide what an adequate amount of therapy should be for a given patient.

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References

  1. 1.
    Wolf AV, Remp DG, Kiley JE, Currie GD (1951) Artificial kidney function: kinetics of hemo-dialysis. J Clin Invest 30: 1062–1070PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Van Slyke DD, Hiller A, Miller BF (1935) The distribution of ferrocyanide, inulin, creatinine and urea in the blood and its effect on the significance of their extraction percentages. Am J Physiol 113: 629–641Google Scholar
  3. 3.
    Michaels AS (1966) Operating parameters and performance criteria for hemodialyzers and other membrane-separation devices. Trans Am Soc Artif Intern Organs 12: 387–392PubMedGoogle Scholar
  4. 4.
    Colton CK, Smith KA, Merrill EW, Farrell PC (1971) Permeability studies with cellulosic membranes. J Biomed Mater Res 5: 459–488PubMedCrossRefGoogle Scholar
  5. 5.
    Colton CK, Lowrie EG (1981) Hemodialysis: Physical principles and technical considerations. In: Brenner BM, Rector FC Jr (eds) The kidney, chap47. Saunders, Philadelphia, pp. 2425–2489Google Scholar
  6. 6.
    Babb AL, Popovich RP, Christopher TG, Scribner BH (1971) The genesis of the square meter-hour hypothesis. Trans Am Soc Artif Intern Organs 17: 81–91, 1971Google Scholar
  7. 7.
    Babb AL, Strand MJ, Uvelli DA, Milutinovic J, Scribner BH (1975) Quantitative description of dialysis treatment: a dialysis index. Kidney Int 7 [Suppl2]: S-23–S-29Google Scholar
  8. 8.
    Scribner BH (1965) Discussion. Trans Am Soc Artif Intern Organs 11: 29Google Scholar
  9. 9.
    Sargent JA, Gotch FA (1975) The analysis of concentration dependence of uremic lesions in clinical studies. Kidney Int 7 [Suppl 2]: S-35–S-44CrossRefGoogle Scholar
  10. 10.
    Gotch FA, Sargent JA, Keen M, Lam M, Prowitt M, Grady M (1976) Clinical results of intermittent dialysis therapy guided by ongoing kinetic analysis of urea metabolism. Trans Am Soc Artif Intern Organs 22: 175–188PubMedGoogle Scholar
  11. 11.
    Popovich RP, Hlavinka DJ, Bomar JB, Moncrief JW, Decherd JF (1975) The consequences of physiological resistances on metabolite removal from the patient-artificial kidney system. Trans Am Soc Artif Intern Organs 21: 108–115PubMedGoogle Scholar
  12. 12.
    Frost TH, Kerr DNS (1977) Kinetics of hemodialysis: A theoretical study of the removal of solutes in chronic renal failure compared to normal health. Kidney Int 12: 41–50PubMedCrossRefGoogle Scholar
  13. 13.
    Sanfellipo ML, Hall DA, Walker WE, Swenson RS (1975) Quantitative evaluation of hemodialysis therapy using a simple mathematical model and a programmable pocket calculator. Trans Am Soc Artif Intern Organs 21: 125–130Google Scholar
  14. 14.
    Borah MF, Schoenfeld PY, Gotch FA, Sargent JA, WolfsonM, Humphreys MH (1978) Nitrogen balance during intermittent dialysis therapy of uremia. Kidney Int 14: 491–500Google Scholar
  15. 15.
    Sargent JA (1983) Control of dialysis by single-pool urea model: the National Cooperative Dialysis Study. Kidney Int 23 [Suppl 13]: S-19–S-25Google Scholar
  16. 16.
    Sargent J, Gotch F, Borah M, Piercy L, Spinozzi N, Schoenfeld P, Humphreys M (1978) Urea kinetics: a guide to nutritional management of renal failure. Am J Clin Nutr 31: 1696–1702PubMedGoogle Scholar
  17. 17.
    Lowrie EG, Sargent JA (1980) Clinical example of pharmacokinetic and metabolic modeling: quantitative and individualized prescription of dialysis therapy. Kidney Int 18 [Suppl 10]: S-ll–S-16Google Scholar
  18. 18.
    Lowrie EG, Teehan BP (1983) Principles of prescribing dialysis therapy: Implementing recommendations from the National Cooperative Dialysis Study. Kidney Int 23 [Suppl 13]: S-113–S-122Google Scholar
  19. 19.
    Ward RA, Shirlow MJ, Hayes JM, Chapman GV, Farrell PC (1979) Protein catabolism during hemodialysis. Am J Clin Nutr 32: 2443–2449PubMedGoogle Scholar
  20. 20.
    Farrell PC, Hone PW (1980) Dialysis-induced catabolism. Am J Clin Nutr 33: 1417–1422PubMedGoogle Scholar
  21. 21.
    Henderson LW, Koch KM, Dinarello CA, Shaldon S (1983) Hemodialysis hypotension: The interleukin hypothesis. Blood Purif 1: 3–8CrossRefGoogle Scholar
  22. 22.
    Dinarello CA (1983) The biology of interleukin-1 and its relevance to hemodialysis. Blood Purif 1: 197–224CrossRefGoogle Scholar
  23. 23.
    Johnson WJ, Hagge WW, Wagoner RD, Dinapoli RP, Rosevear JW (1972) Effects of urea loading in patients with far-advanced renal failure. Mayo Clin Proc 47: 21–29PubMedGoogle Scholar
  24. 24.
    Shaldon S (1966) Haemodialysis in chronic renal failure. Postgrad Med J 42: 669–695Google Scholar
  25. 25.
    Henderson LW (1973) The problem of peritoneal membrane area and permeability. Kidney Int 3: 409–410PubMedCrossRefGoogle Scholar
  26. 26.
    Babb AL, Farrell PC, Strand MJ, Uvelli DA, MilutinovicJ, ScribnerBH (1972) Residual renal function and chronic hemodialysis therapy. Proc Dial Transplant Forum 2: 142–148Google Scholar
  27. 27.
    Lowrie EG, Lard NM (1983) Cooperative dialysis study. Kidney Int 23 [Suppl 13]: S-l–S-122Google Scholar
  28. 28.
    Laird NM, Berkey CS, Lowrie EG (1983) Modeling success or failure of dialysis therapy: the National Cooperative Dialysis Study. Kidney Int 23 [Suppl 13]: S-101–S-106Google Scholar
  29. 29.
    Wing AJ, Broyer M, Brunner FP, Brynger H, Donckerwolcke RA, Jacobs C, Kramer P, Selwood NH (1981) Combined report on regular dialysis and transplantation in Europe. 19th Proceedings of the European Dialysis and Transplant AssociationGoogle Scholar
  30. 30.
    Bosch JP, von Albertini B, GlabmanS (1982) Prescription for hemofiltration. Contrib Nephrol 32: 137–145PubMedGoogle Scholar
  31. 31.
    CanaudB, MayrH, GarredLJ, Farrell PC, MionC (1983) Urea kinetic model for hemofiltration. Blood Purif 1: 42 (Abstract)CrossRefGoogle Scholar
  32. 32.
    Canaud B, Mayr H, Araujo A, Garred LJ, Farrel PC, Mion C (1983) Protein catabolic changes induced by postdilution hemofiltration. Blood Purif 1: 42 (Abstract)CrossRefGoogle Scholar
  33. 33.
    Walser(1981) Conservative management of the uremic patient. In: Brenner BM, Rector FC Jr (eds) The kidney, chap 46. Saunders, Philadelphia, pp 2383–2424Google Scholar
  34. 34.
    Quellhorst EA, Schuenemann B, Hildebrand U (1983) Morbidity and mortality in long-term hemofiltration. asaio J 6: 185–191Google Scholar
  35. 35.
    Gotch FA (1980) A quantitative evaluation of small and middle molecule toxicity in therapy of uremia. Dial Transpl 10 (3): 184–194Google Scholar
  36. 36.
    Blumenkrantz MJ, Kopple JD, Moran JK, Grodstein GP, Coburn JW (1981) Nitrogen and urea metabolism during continuous ambulatory peritoneal dialysis. Kidney Int 20: 78–82PubMedCrossRefGoogle Scholar
  37. 37.
    Randerson DH, Chapman GV, Farrell PC (1981) Amino acid and dietary status in CAPD patients. In: Atkins RC, Thomson NM, Farrell PC (eds) Peritoneal dialysis. Churchill Livingstone, New York, pp 179–191Google Scholar
  38. 38.
    Leypoldt JK, Frigon RP, Henderson LW (1983) Sieving coefficients of hemofiltration membranes. Trans Am Soc Artif Intern Organs 29: 678–683PubMedGoogle Scholar
  39. 39.
    Channard J, Brunois JP, Melin JP, Lavaud S, Toupance O (1982) Long-term results of dialysis therapy with a highly permeable membrane. Artif Organs 6: 261–266CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • L. W. Henderson
  • J. K. Leypoldt

There are no affiliations available

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