An analysis of thermal regulation in hemodialysis with one and three compartment models.
A one compartment model of heat kinetics in hemodialysis (HD) was formulated, solved for the body surface heat transfer coefficient, and used to analyze reported clinical data. The analysis showed a linear relationship between percent change in body surface (y) and fractional dialyzer (x) heat loss, such that y = -25 - 44X, p less than 0.001. Thus, when X = 0, surface heat loss decreases 25% and core temperature (T) rises, and X must equal 45% of heat production to stabilize core T during HD. A three compartment model predicts that skin clothing insulation will have to increase 2.5 times to avoid thermal discomfort when X = 45% of heat production. A theoretic mechanism for decreased symptomatic hypotension resulting from stabilization of core T is proposed.
Gotch
F A
FA
Hemodialysis Treatment & Research Center, Davies Medical Center, San Francisco, California.
Keen
M L
ML
Yarian
S R
SR
D001794:Blood Pressure / Q000502:physiology; D001833:Body Temperature Regulation / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D007700:Kinetics; D008962:Models, Theoretical; D006435:Renal Dialysis / Q000379:methods*