title: Prediction of hemodialysis sorbent cartridge urea nitrogen capacity and sodium release from in vitro tests.
abstract: In sorbent-based hemodialysis, factors limiting a treatment session are urea conversion capacity and sodium release from the cartridge. In vitro experiments were performed to model typical treatment scenarios using various dialyzers and 4 types of SORB sorbent cartridges. The experiments were continued to the point of column saturation with ammonium. The urea nitrogen removed and amount of sodium released in each trial were analyzed in a multi-variable regression against several variables: amount of zirconium phosphate (ZrP), dialysate flow rate (DFR), simulated blood flow rate (BFR), simulated patient whole-body fluid volume (V), initial simulated patient urea concentration (BUNi), dialyzer area permeability (KoA) product, initial dialysate sodium and bicarbonate (HCO3i) concentrations, initial simulated patient sodium (Nai), pH of ZrP, creatinine, breakthrough time, and average urea nitrogen concentration in dialysate. The urea nitrogen capacity (UNC) of various new SORB columns is positively related to ZrP, BFR, V, BUNi, and ZrP pH and negatively to DFR with an R2 adjusted=0.990. Two models are described for sodium release. The first model is related positively to DFR and V and negatively to ZrP, KoA product, and dialysate HCO3i with an R2 adjusted=0.584. The second model incorporates knowledge of initial simulated patient sodium (negative relationship) and urea levels (negative relationship) in addition to the parameters in the first model with an R2 adjusted=0.786. These mathematical models should allow for prediction of patient sodium profiles and the time of column urea saturation based on simple inputs relating to patient chemistries and the dialysis treatment.
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Rosenbaum
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Ash
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Wong
authors.forename: R Preston
authors.initials: RP
authors.lastname: Thompson
authors.forename: David J
authors.initials: DJ
authors.lastname: Carr
mesh_terms: D000327:Adsorption; D001806:Blood Urea Nitrogen; D015312:Hemodialysis Solutions; D006801:Humans; D066298:In Vitro Techniques; D008954:Models, Biological; D012044:Regression Analysis; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*; D012964:Sodium / Q000097:blood / Q000302:isolation & purification*; D014508:Urea / Q000097:blood / Q000302:isolation & purification*
chemical_list: D015312:Hemodialysis Solutions; D014508:Urea; D012964:Sodium