NDLI: Model-based analysis of Na-K+ pump influence on potassium depuration during Acetate Free Biofiltration (AFB)

Content Provider	IEEE Xplore Digital Library
Author	Ciandrini, A. Severi, S. Cavalcanti, S. Grandi, F. Santoro, S.
Copyright Year	2008
Description	Author affiliation: Dept. of Electron., Comput. Sci. & Syst., Univ. of Bologna, Bologna (Ciandrini, A.; Severi, S.; Cavalcanti, S.) \|\| Hospal spa Bologna, Bologna (Grandi, F.) \|\| Dept. of Nephrology & Urology, Sant'Orsola-Malpighi Hosp., Bologna (Santoro, S.)
Abstract	Potassium ion $(K^{+})$ kinetics in intra and extracellular compartments during hemodialysis was studied by means of a double-pool computer model which included potassium-dependent active transport (Na-K-ATPase pump) in thirty-four patients (21M/13F; aged 66 plusmn 22 years old, dry weight 68 plusmn 18 kg, height 160 plusmn 15 cm) on renal replacement therapy with thrice weekly 4 hour double-needle hemodialysis. Each patient was studied during acetate free biofiltration (AFB) with a constant $K^{+}$ dialysate concentration $(K_{CONST}$ therapy) and with a time-varying (profiled) $K^{+}$ dialysate concentration $(K_{PROF}$ therapy). The two therapies induced different levels of $K^{+}$ plasma concentration $(K_{CONST}:$ 3.6plusmn0.8 vs. $K_{PROF}:$ 4.0plusmn0.7 mmol/L, time-averaged values, p<0.01). The computer model was tuned to accurately fit plasmatic $K^{+}$ measured in the course of $K_{CONST}$ and $K_{PROF}$ therapies and was then used to simulate the kinetics of intra and extracellular $K^{+}.$ Model-based analysis showed that almost all the $K^{+}$ removal in the first 90 minutes of dialysis was mainly derived from the extracellular compartment. The different $K^{+}$ time course in the dialysate and the consequently different Na-K pump activity resulted in a different sharing of removed potassium mass at the end of dialysis: 55+17% from the extracellular compartment in $K^{+}$ $_{PROF}$ vs. 41plusmn14% in $K^{+}$ $_{CONST}.$ These results suggest that the Na-K pump plays a major role in $K^{+}$ apportionment between extracellular and intracellular compartments, and potassium dialysate concentration strongly influences pump activity. For this reason the computer-model here presented may represent a useful tool to quantitatively assess the impact of dialysate potassium on $K^{+}$ kinetics in intra and extracellular compartments and to design dialysate potassium content tailored to the patient's needs.
Starting Page	873
Ending Page	875
File Size	176302
Page Count	3
File Format	PDF
ISBN	9781424437061
ISSN	02766547
DOI	10.1109/CIC.2008.4749181
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2008-09-14
Publisher Place	Italy
Access Restriction	Subscribed
Rights Holder	Computers in Cardiology(CinC)
Subject Keyword	Extracellular Medical treatment Kinetic theory Plasma measurements Plasma simulation Aging Computer science Hypertension Hospitals Computational modeling
Content Type	Text
Resource Type	Article

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