Solute solver ‘what if’ module for modeling urea kinetics

Daugirdas, John T.

doi:10.1093/ndt/gfw311

Cited by 17 publications

(21 citation statements)

References 13 publications

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“…The average in vivo K 0 A values were 40–79% of the in vitro values reported by the manufacturer, had only small differences between the models and wide variation within each model (Table ). Daugirdas uses 53.7% in the “what if” module . In the present study, the actual in vivo K 0 A of the modeling session was used in generating the new prescription.…”

Section: Resultsmentioning

confidence: 99%

“…Possible explanations are inaccuracy of the OCM devices or of the blood or dialysate pumps, of the Michaels’ equation or the clearance definition (E = K × C). The Michaels’ equation has been corrected several times …”

Section: Discussionmentioning

confidence: 99%

“…The modified stdKt/V has been adopted also into the KDOQI 2015 guidelines and the Solute Solver “what if” module . The stdK/V calculation method of the Solute Solver program has been changed after its first publication in 2009 .…”

Section: Methodsmentioning

confidence: 99%

“…The modified stdKt/V has been adopted also into the KDOQI 2015 guidelines and the Solute Solver "what if" module. 2,6 The stdK/V calculation method of the Solute Solver program has been changed after its first publication in 2009. 5 In this study, however, the classic stdK/V calculation method (Equation 2) is used in generating the optimized prescription and the value compared to the stdK/V target, but also the Daugirdas' modified stdKt/V is shown by the demonstration program.…”

Section: Residual Renal Functionmentioning

confidence: 99%

“…Daugirdas uses 53.7% in the "what if" module. 6 In the present study, the actual in vivo K 0 A of the modeling session was used in generating the new prescription.…”

Section: Dialyzersmentioning

confidence: 99%

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Automatic hemodialysis prescriptions by urea kinetic modeling

Vartia

2019

Hemodialysis International

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Introduction Guidelines on hemodialysis (HD) dosing are based on urea kinetics, which can be modeled mathematically. Different schedules can be compared by equivalent continuous clearance. Methods A computer program generating HD prescriptions automatically was developed. In 200 actual HD urea kinetic modeling sessions involving 33 patients the urea distribution volume, generation rate, and concentration profile in the external space were computed using ionic dialysance as dialyzer clearance in the double pool ureakinetic model. Dialyzer in vivo mass area coefficient K0A was calculated from online data with the Michaels’ equation. Data from the modeling sessions were used for generating new prescriptions for the same patients. Findings New prescriptions meeting 12 criteria—technical limits and guideline targets—were generated by the model. They showed a wide range of basic treatment parameters (time and frequency, blood and dialysate flow, and ultrafiltration). In five cases, the dialysis time or frequency should have been increased from the actual to achieve the targets, in 72 cases the frequency could have been decreased. Two methods to emphasize RRF were tested. Using a coefficient of 2.0 for renal urea clearance in computing adjusted equivalent continuous clearance (EKR/Va), as suggested by Casino and Basile, decreased further the required treatment frequency in incremental dialysis. Discussion The model produced plausible individual prescriptions, but some unknown factors caused the determination of the dialyzer in vivo K0A to be inaccurate. The model must be tested with modern devices on patients before integration into dialysis machines and information systems.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Residual Renal Functionmentioning

confidence: 99%

“…Daugirdas uses 53.7% in the "what if" module. 6 In the present study, the actual in vivo K 0 A of the modeling session was used in generating the new prescription.…”

Section: Dialyzersmentioning

confidence: 99%

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