Impact of solute exchange between erythrocytes and plasma on hemodialyzer clearance

• Autorzy: Waniewski J. , Poleszczuk J. , Pietribiasi M. , Debowska M. , Wojcik-Zaluska A. , Zaluska W.

Identyfikatory

DOI

10.1016/j.bbe.2019.04.003

• Języki publikacji: EN

Abstrakty

EN

The standard theory of mass transport in dialyzer for water solutions was extended for solutes distributed in both plasma (PW) and erythrocyte intracellular (EW) water. Blood flow was divided into two separate flows of PW and EW with the diffusive exchange of solutes across cellular membrane (CM). Diffusive permeability of CM for urea and creatinine were assumed according to literature data. Computer simulations based on partial differential equations demonstrated that urea diffuses fast across CM and can be approximately considered as distributed uniformly in both blood flow components. In contrast, creatinine can be considered as distributed only in PW flow during the passage along the dialyzer. Therefore, the traditional formula for dialyzer clearance can be applied for urea and creatinine with the adjustment of their effective ‘‘blood’’ flow, but not for solutes with intermediate molecular mass. In vivo clearances of urea and creatinine were, as expected, lower than the respective theoretical predictions based of the diffusive permeability, P, times membrane surface area, A, parameters, PA, for dialyzer membrane, estimated for water solutions, by 33.6 ± 10.9% for creatinine and 10.8 ± 9.4% for urea. The estimated in vivo PAs were for creatinine 65.4 ± 26.0% and for urea 32.0 ± 10.9% lower than in vitro values provided by manufacturers. The much higher drop in clinical clearance/PA for creatinine than for urea suggests that the exchange of creatinine between plasma and dialysis fluid needs to be adjusted for the reduction of the dialyzer membrane surface area, which is effectively available for creatinine, caused by the presence of erythrocytes.

Słowa kluczowe

EN

membrane transport; dialyzer clearance; diffusive permeability; cellular membrane; urea; creatinine

PL

transport membranowy; przepuszczalność dyfuzyjna; błona komórkowa; mocznik; kreatynina

• Wydawca: Nałęcz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences ; Elsevier
• Czasopismo: Biocybernetics and Biomedical Engineering
• Rocznik: 2020
• Tom: Vol. 40, no. 1
• Strony: 265--276
• Opis fizyczny: Bibliogr. 23 poz., rys., tab., wykr.

Twórcy

autor

Waniewski J.

• Nalecz Institute of Biocybernetics and Biomedical Engineering PAS, Trojdena 4, PL 02-109 Warsaw, Poland

autor

Poleszczuk J.

• Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Trojdena 4, 02-109 Warsaw, Poland

autor

Pietribiasi M.

• Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Trojdena 4, 02-109 Warsaw, Poland

autor

Debowska M.

• Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Trojdena 4, 02-109 Warsaw, Poland

autor

Wojcik-Zaluska A.

• Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland

autor

Zaluska W.

• Department of Nephrology, Medical University of Lublin, Lublin, Poland

Bibliografia

• [1] Werynski A, Waniewski J. Theoretical description of mass transport in medical membrane devices. Artif Organs 1995;19(5):420–7.
• [2] Waniewski J. Mathematical modeling of fluid and solute transport in hemodialysis and peritoneal dialysis. J Membr Sci 2006;274:24–37.
• [3] Sigdell JE. A mathematical theory for the capillary artificial kidney. Stuttgart: Hippokrates Verlag; 1974.
• [4] Jaffrin MY, Gupta BB, Malbrancq JM. A one dimensional model of simultaneous hemodialysis and ultrafiltration with highly permeable membranes. J Biomech Eng 1981;103:261–6.
• [5] Sigdell JE. General description of passive transport of neutral solute and solvent through membranes. Int J Artif Organs 1982;5:361–72.
• [6] Waniewski J, Werynski A, Ahrenholz P, Lucjanek P, Judycki W, Esther G. Theoretical basis and experimental verification of the impact of ultrafiltration on dialyzer clearance. Artif Organs 1991;15(2):70–7.
• [7] Galach M, Ciechanowska A, Sabalinska S, Waniewski J, Wójcicki J, Werynski A. Impact of convective transport on dialyzer clearance. J Artif Organs 2003;6(1):42–8.
• [8] Legallais C, Catapano G, von Harten B, Baurmeister U. A theoretical model to predict the in vitro performance of hemodialyzers. J Membr Sci 2000;168:3–15.
• [9] Waniewski J, Lucjanek P, Werynski A. Alternative descriptions of combined diffusive and convective mass transport in hemodialyzer. Artif Organs 1993;17 (1):3–7.
• [10] Waniewski J, Lucjanek P, Werynski A. Impact of ultrafiltration on back-diffusion in hemodialyzer. Artif Organs 1994;18(12):933–6.
• [11] Drukker, Parsons, Maher. In: Hörl WH, Koch K-MM., Lindsay RM, Ronco C, Winchester JF, editors. Replacement of renal function by dialysis. Dordrecht: Kluver Academic Publishers; 2004.
• [12] Eloot S, Torremans A, De Smet R, Marescau B, De Deyn PP, Verdonck P, et al. Complex compartmental behavior of small water-soluble uremic retention solutes: evaluation by direct measurements in plasma and erythrocytes. Am J Kidney Dis 2007;50(2):279–88.
• [13] Schneditz D, Platzer D, Daugirdas JT. A diffusion-adjusted regional blood flow model to predict solute kinetics during haemodialysis. Nephrol Dial Transplant 2009;24(7):2218–24.
• [14] Schneditz D, Yang Y, Christopoulos G, Kellner J. Rate of creatinine equilibration in whole blood. Hemodial Int 2009;13(2):215–21.
• [15] Daugirdas JT, Blake PG, Ing TS. Handbook of dialysis. 5th ed. Wolters Kluwer Health; 2015.
• [16] Waniewski J. Theoretical foundations for modeling of membrane transport in medicine and biomedical engineering. Warsaw: Institute of Computer Science, Polish Academy of Sciences; 2015.
• [17] Fournier RL. Basic transport phenomena in biomedical engineering. New York: Taylor & Francis; 2007.
• [18] Guyton AC, Hall JE. Textbook of medical physiology. Philadelphia: W.B. Saunders Company; 2000.
• [19] Lentner C, editor. Geigy scientific tables, vol. 3: physical chemistry, composition of blood, hematology, somatometric data. Basle: CIBA-GEIGY; 1984.
• [20] Debowska M, Wojcik-Zaluska A, Ksiazek A, Zaluska W, Waniewski J. Phosphate, urea and creatinine clearances: haemodialysis adequacy assessed by weekly monitoring. Nephrol Dial Transplant 2015;30(1):129–36.
• [21] Sargent JA, Marano M, Marano S, Gennari FJ. Acid–base homeostasis during hemodialysis: new insights into the mystery of bicarbonate disappearance during treatment. Seminars Dialysis 2018;31(5):468–78.
• [22] Pietribiasi M, Waniewski J, Wójcik-Zaluska A, Zaluska W, Lindholm B. Model of fluid and solute shifts during hemodialysis with active transport of sodium and potassium. PLoS One 2018;13(12):e0209553.
• [23] Waniewski J, Debowska M, Wojcik-Zaluska A, Ksiazek A, Zaluska W. Quantification of dialytic removal and extracellular calcium mass balance during a weekly cycle of hemodialysis. PLoS One 2016;11(4):e0153285.

Uwagi

PL

Opracowanie rekordu ze środków MNiSW, umowa Nr 461252 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2020).