A mathematical model of continuous arterio-venous hemodiafiltration (CAVHD)

Continuous arterio-venous hemodiafiltration (CAVHD) differs from conventional hemofiltration and dialysis by the interaction of convection and diffusion, the use of very low dialysate flow rates and by the deterioration of membrane conditions during the treatment. In order to study the impact of these phenomena on diffusive transport, we developed a mathematical model of the kinetics of CAVHD solute transport from plasma water to dialysate. The model yields an expression of the diffusive mass transfer coefficient, Kd, as a function of blood, filtrate and dialysate flow rates and solute concentrations, which can be measured in the clinical setting. This paper gives a description of the model derivation. Kd is demonstrated to vary depending on dialysate flow and duration of treatment.