title: Simulation analysis of the influence of hemodialysis control parameters on exchange processes during therapy.
abstract: The effect of dialysis control parameters (dialysate composition, ultrafiltration rate, blood flow rate) on the patient's internal milieu were studied using a mathematical model for the description of the dynamic exchange processes during hemodialysis. This model simulates the electrolyte and water distribution, the acid-base and the oxygenation state as well as the ventilation. The dialysate sodium concentration affects mainly the intra-/extracellular water and the potassium distribution. The dialysate bicarbonate and acetate concentrations control the acid-base state and the electrolyte distribution (sodium and potassium). In addition, the dialysate acetate concentration has a strong effect on arterial oxygenation and on ventilation. The ultrafiltration rate controls the water distribution between plasma and the interstitial space but also the sodium distribution and the arterial acid-base state. The blood flow rate through the dialyser influences the acid-base state and, by this, it affects the potassium and sodium distribution. The acid-base state is affected in opposite directions when acetate or bicarbonate is used as a buffer.
authors.affiliation: Institute of Physiology and Pathophysiology, Johannes Gutenberg-University, Mainz, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Thews
mesh_terms: D000085:Acetates / Q000494:pharmacology; D000136:Acid-Base Equilibrium / Q000502:physiology*; D001639:Bicarbonates / Q000494:pharmacology; D003198:Computer Simulation; D015312:Hemodialysis Solutions / Q000494:pharmacology; D006801:Humans; D007474:Ion Exchange; D008962:Models, Theoretical; D011188:Potassium / Q000494:pharmacology; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D006435:Renal Dialysis; D012964:Sodium / Q000494:pharmacology; D014462:Ultrafiltration; D014882:Water-Electrolyte Balance / Q000502:physiology*
chemical_list: D000085:Acetates; D001639:Bicarbonates; D015312:Hemodialysis Solutions; D012964:Sodium; D011188:Potassium