Kinetic Modeling of "Go Slow" Dialysis in Acute Renal Failure

Go slow" dialysis is a gentle, intermittent hemodialysis therapy for acute renal failure patients, with advantages compared to slow, continuous therapies. It employs a recirculating closed dialysate circuit. A two-pool urea kinetic model is elaborated to determine kinetic parameters from blood and dialysate concentrations. This will allow quantification of the therapy. Variable clearance is included to accurately describe the kinetic process. The model is tested in an acute renal failure patient. Solute removals, as determined from direct dialysis quantification and by the model, are comparable. Variable clearance is not required to determine the kinetic parameters, because the constant mean clearance delivers equal results. The dialysis dose, as defined, allows comparison with chronic renal therapies. It requires solute removal determined from dialysate sampling and time-averaged concentration (TAC) from the urea kinetic modeling. In the test patient, dialysis dose is lower compared to standard thrice-weekly therapies because of its lower efficiency and higher TAC, a result of his highly catabolic state.