Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

The cellular clearance theory does not explain the post-dialytic small molecule rebound

J G Heaf1, S B Jensen, K Jensen

  • 1Department of Nephrology, State University Hospital, Copenhagen, Denmark.

Scandinavian Journal of Urology and Nephrology
|November 24, 1998
PubMed
Summary

The two-pool model accurately predicts urea rebound in hemodialysis patients, but not creatinine or phosphate. Post-dialysis solute rebound can be reduced by preventing hypotension and using calcium antagonists.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Analytical solution of phosphate kinetics for hemodialysis.

Journal of mathematical biology·2023
Same author

Effect of far infrared therapy on arteriovenous fistula maturation, survival and stenosis in hemodialysis patients, a randomized, controlled clinical trial: the FAITH on fistula trial.

BMC nephrology·2021
Same author

Mortality due to bleeding, myocardial infarction and stroke in dialysis patients.

Journal of thrombosis and haemostasis : JTH·2018
Same author

Electromagnetically induced transparency in a diamond spin ensemble enables all-optical electromagnetic field sensing.

Physical review letters·2013
Same author

Transient impairments in single muscle fibre contractile function after prolonged cycling in elite endurance athletes.

Acta physiologica (Oxford, England)·2013
Same author

SSRIs: a premature burial.

Clinical pharmacology and therapeutics·2012

Area of Science:

  • Nephrology
  • Biomedical Engineering
  • Pharmacology

Background:

  • Maintenance hemodialysis aims to clear waste products like urea, creatinine, and phosphate.
  • Accurate assessment of solute clearance is crucial for optimizing dialysis efficacy.
  • Understanding factors influencing solute rebound is important for patient management.

Purpose of the Study:

  • To determine normalized cellular clearance (Kcn) of urea, creatinine, and phosphate in hemodialysis patients.
  • To identify factors, particularly circulatory, affecting Kcn.
  • To assess if intra-dialytic blood sampling can predict post-dialytic solute rebound.

Main Methods:

  • Kinetic modeling using a two-pool variable volume computer simulation.
  • Analysis of 34 patients undergoing maintenance dialysis on two separate occasions.

Related Experiment Videos

  • Determination of cellular clearance via post-dialytic rebound and mid-dialytic blood samples.
  • Echocardiography and peripheral blood pressure measurements were performed.

    • Main Results:

    • The two-pool model accurately measured urea rebound Kcn (93%) but showed lower accuracy for creatinine (49%) and phosphate (13%).
    • High post-dialytic rebounds (low Kcn) correlated with erythropoietin use and end-dialytic hypotension.
    • Calcium antagonist treatment was associated with significantly higher Kcn (p < 0.001).
    • No correlation was found between mid-dialysis and rebound Kcn; circulatory indices did not influence Kcn.

    Conclusions:

    • The two-pool model is suitable for urea kinetics but not for creatinine or phosphate in hemodialysis.
    • Post-dialytic solute rebound may be iatrogenic and can be mitigated by preventing hypotension and using calcium antagonists.
    • Intra-dialytic blood sampling cannot reliably predict the magnitude of post-dialytic solute rebound.