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Related Concept Videos

Hemodialysis I: Introduction01:25

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Related Experiment Video

Updated: Feb 4, 2026

Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb
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Does the plasma refilling coefficient change during hemodialysis sessions?

Mauro Pietribiasi1, Alicja Wójcik-Załuska2, Wojciech Załuska3

  • 11 Department of Modeling and Supporting of Internal Organs Functions, Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland.

The International Journal of Artificial Organs
|October 4, 2018
PubMed
Summary

The refilling coefficient during hemodialysis may decrease due to unmeasured changes in Starling forces, not just filtration coefficient changes. Accounting for these forces offers a more accurate understanding of plasma refilling dynamics.

Keywords:
HemodialysisStarling forcesfiltration coefficientmathematical modelingplasma refillingrefilling coefficient

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Area of Science:

  • Nephrology
  • Physiology
  • Biomedical Engineering

Background:

  • The filtration coefficient is key to plasma refilling in hemodialysis.
  • The refilling coefficient, an estimate of filtration coefficient, assumes only oncotic pressure drives refilling.
  • Observed decreases in refilling coefficient were previously attributed to filtration coefficient changes.

Purpose of the Study:

  • To offer an alternative explanation for the refilling coefficient's behavior during hemodialysis.
  • To predict immeasurable Starling forces using clinical data and mathematical modeling.
  • To establish a theoretical basis for interpreting the refilling coefficient.

Main Methods:

  • Utilized blood volume and bioimpedance data from 23 hemodialysis patients.
  • Calculated the refilling coefficient using the original formulation.
  • Fitted a two-compartment model for protein and fluid transport.

Main Results:

  • Changes in other Starling forces were significant (19-60% of plasma oncotic pressure).
  • The decrease in refilling coefficient is likely due to neglecting these Starling force changes.
  • Constant filtration coefficient and dynamic refilling coefficient equivalently described most data when other forces were considered.

Conclusions:

  • The observed decrease in refilling coefficient during hemodialysis is likely an artifact of neglecting significant Starling force variations.
  • Considering these forces provides a more accurate model of plasma refilling.
  • Further investigation is needed for sessions where this model doesn't fully explain the refilling coefficient behavior.