title: A physiologically based model of vascular refilling during ultrafiltration in hemodialysis.
abstract: An assessment of fluid status can be obtained by monitoring relative blood volume (RBV) during hemodialysis (HD) treatment. The dynamics of RBV is determined by fluid removal from the intravascular compartment by ultrafiltration (UF) and vascular refill from the interstitium. To characterize this dynamics, a two-compartment model describing the short-term dynamics of vascular refilling and UF is developed. Fluid movement between the compartments is governed by lymphatic and microvascular fluid shifts. Further, protein flux is described by convection, diffusion and the lymphatic protein flux. Patient specific parameters are identified based on hematocrit (Hct) measurements by the Crit-Line monitor (CLM). Different measurement frequencies and UF profiles are compared to determine data fidelity and influence on the quality of parameter estimates. This relevant information can be used to assess the (patho)physiological status of hemodialysis patients and could aid in individualizing therapy.
authors.affiliation: Institute of Mathematics, University of the Philippines Diliman, C.P. Garcia St., U.P. Campus, Diliman, 1101 Quezon City, Philippines.
authors.forename: Aurelio A
authors.initials: AA
authors.lastname: de los Reyes V
authors.affiliation: Renal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY 10065, USA.
authors.forename: Doris H
authors.initials: DH
authors.lastname: Fuertinger
authors.affiliation: Institute for Mathematics and Scientific Computing, University of Graz, Heinrichstraße 36, A-8010 Graz, Austria. Electronic address: franz.kappel@uni-graz.at.
authors.forename: Franz
authors.initials: F
authors.lastname: Kappel
authors.affiliation: Renal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY 10065, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Meyring-Wösten
authors.affiliation: Renal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY 10065, USA.
authors.forename: Stephan
authors.initials: S
authors.lastname: Thijssen
authors.affiliation: Renal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY 10065, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
mesh_terms: D000465:Algorithms; D001810:Blood Volume / Q000502:physiology*; D001826:Body Fluids / Q000378:metabolism*; D015314:Dialysis Solutions / Q000378:metabolism*; D006400:Hematocrit; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D008962:Models, Theoretical; D006435:Renal Dialysis; D013997:Time Factors; D014462:Ultrafiltration
chemical_list: D015314:Dialysis Solutions
keywords: Blood volume monitoring; Capillary fluid exchange; Filtration coefficient; Mathematical modeling; Microvascular permeability; Parameter estimation