Long-term follow-up of renal osteodystrophy in chronic dialysis patients

Sugisaki, Hiroaki; Nakajima, M.; Kunitomo, Tetsunosuke; Maruyama, Kana

doi:10.4009/jsdt1985.20.147

Cited by 4 publications

(6 citation statements)

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“…Management of complications relating to circuit clotting in HD is central, because it remains an unsolved issue (Laville et al, 2014;Liang, 2016;Lorentz et al, 2021). et al, 1989;Spalding et al, 2002;Sugisaki et al, 1983). The results illustrated in Figure 4 show no correlation between the identified clearance reduction slopes from the 24 treatments and the corresponding plasma phosphate levels at the 3 h time point.…”

Section: Discussionmentioning

confidence: 96%

Implementation of a coagulation component into a phosphate kinetics model in haemodialysis therapy: A tool for detection of clotting problems?

Laursen,

Boel,

Brandi

et al. 2023

Experimental Physiology

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A coagulation component should be considered in phosphate kinetics modelling because intradialytic coagulation of the extracorporeal circuit and dialyser might reduce phosphate removal in haemodialysis. Thus, the objective of this study was to add and evaluate coagulation as an individual linear clearance reduction component to a promising three‐compartment model assuming progressive intradialytic clotting. The model was modified and validated on intradialytic plasma and dialysate phosphate samples from 12 haemodialysis patients collected during two treatments (HD1 and HD2) at a Danish hospital ward. The most suitable clearance reduction in each treatment was identified by minimizing the root mean square error (RMSE). The model simulations with and without clearance reduction were compared based on RMSE and coefficient of determination (R2) values. Improvements were found for 17 of the 24 model simulations when clearance reduction was added to the model. The slopes of the clearance reduction were in the range of 0.011–0.632/h. Three improvements were found to be statistically significant (|observed z value| > 1.96). A very significant correlation (R2 = 0.708) between the slopes for HD1 and HD2 was found. Adding the clearance reduction component to the model seems promising in phosphate kinetics modelling and might be explained, at least in part, by intradialytic coagulation. In future studies, the model might be developed further to serve as a potentially useful tool for the quantitative detection of clotting problems in haemodialysis.New Findings What is the central question of this study? The aim was to add an intradialytic coagulation component to a modified version of a promising three‐compartment phosphate kinetics model. The hypothesis was that circuit and dialyser clotting can be modelled by an individual linear phosphate clearance reduction component during haemodialysis treatment. What is the main finding and its importance? Improvements were found for 17 of 24 model simulations when clearance reduction was added to the model. Thus, the kinetics model seems promising and could be a useful tool for the quantitative detection of clotting problems in haemodialysis patients.

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Section: Discussionmentioning

confidence: 96%

Implementation of a coagulation component into a phosphate kinetics model in haemodialysis therapy: A tool for detection of clotting problems?

Laursen,

Boel,

Brandi

et al. 2023

Experimental Physiology

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“…rebound [19,20]. Gotch et al (2003) defined P elimination models using patient-specialized intradialytic P transfer measures [4].…”

Section: Discussionmentioning

confidence: 99%

“…Of note, several forms of such models were proposed. Early records recommended that a traditional model did not apply to P elimination and could not be utilized to predict post‐dialysis P rebound [19, 20]. Gotch et al (2003) defined P elimination models using patient‐specialized intradialytic P transfer measures [4].…”

Section: Discussionmentioning

confidence: 99%

Phosphate kinetic modeling as an estimate of daily ingested phosphate in hemodialysis patients with or without residual kidney function

Samaan,

Nagah,

El Said

2023

Ther Apher Dial

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Background and AimDaugirdas suggested a 2‐pool phosphate kinetic model based on his previously established urea kinetic model. The current study aims to assess the level of agreement between the modeled daily ingested phosphorus (DIP) values and the routine method of dietary recall calculations in hemodialysis patients.MethodThe study was conducted on 100 hemodialysis patients; 50 were anuric, and the others had residual kidney function (RKF). The level of correlation and agreement between the dietary calculated and modeled DIP were assessed in both study groups.ResultsA statistically significant positive correlation existed between the calculated and modeled DIP (r = 0.79 for the anuric group, r = 0.84 for the RKF group, p < 0.001). There was a significant level of agreement between calculated and modeled DIP in RKF patients only.ConclusionThese findings suggest that phosphate modeling can estimate phosphate intake in RKF patients and be cost‐effective in their management.

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“…Considering the large societal problem of malfunctioning renal function, relatively few mathematical models have been proposed since the first contribution by Sugisaki et al. ( 1982 ). Laursen et al.…”

Section: Introductionmentioning

confidence: 99%

Analytical solution of phosphate kinetics for hemodialysis

et al. 2023

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Chronic kidney diseases imply an ongoing need to remove toxins, with hemodialysis as the preferred treatment modality. We derive analytical expressions for phosphate clearance during dialysis, the single pass (SP) model corresponding to a standard clinical hemodialysis and the multi pass (MP) model, where dialysate is recycled and therefore makes a smaller clinical setting possible such as a transportable dialysis suitcase. For both cases we show that the convective contribution to the dialysate is negligible for the phosphate kinetics and derive simpler expressions. The SP and MP models are calibrated to clinical data of ten patients showing consistency between the models and provide estimates of the kinetic parameters. Immediately after dialysis a rebound effect is observed. We derive a simple formula describing this effect which is valid both posterior to SP or MP dialysis. The analytical formulas provide explanations to observations of previous clinical studies.

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Long-term follow-up of renal osteodystrophy in chronic dialysis patients

Cited by 4 publications

References 0 publications

Implementation of a coagulation component into a phosphate kinetics model in haemodialysis therapy: A tool for detection of clotting problems?

Implementation of a coagulation component into a phosphate kinetics model in haemodialysis therapy: A tool for detection of clotting problems?

Phosphate kinetic modeling as an estimate of daily ingested phosphate in hemodialysis patients with or without residual kidney function

Analytical solution of phosphate kinetics for hemodialysis

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