Cardiovascular stability and patient dependent mass transfer during dialysis

A better patient cardiovascular stability to haemodialysis (HD) has proved to be related to therapy customization. To this aim the development of a patient- dependent mass transfer model would play a key role. On the other hand the patient and machine parameters monitoring would allow the calculation of indexes characterizing the peculiar response to HD. A total of 18 patients undergoing standard HD were enrolled. Blood volume variation, ultrafiltration rate and other relevant intra-dialysis parameters were monitored at scheduled times during HD sessions over one month. A three-pool model of mass transfer in patients undergoing HD was developed and interfaced to a simulated HD filter. The model was customized taking into account capillary permeability and arterial compliance variation according to patient age. The effect induced by different dialysis filters was also studied. Based on the recorded data the Plasma Refilling Index (PRI) was calculated. The model outputs were consistent with the clinical recorded parameters. PRI trend resulted to be distinctive of each patient and to highlight dry weight overestimation.