Exploiting compartmental models of solute clearance in haemodialysis

The significance of kinetic models of solute clearance during dialysis lies not simply in the determination of dialysis dose but in the simulation and assessment of novel dialysis techniques. In this paper a two-pool model of solute kinetics in which blood flow is the dominant transport mechanism, is used to simulate haemodialysis using dialysis with varying solute clearance and different distributions of flow between the high and low flow tissue compartments for constant systemic blood flow (5 l/min). The results demonstrate that the mass of solute removed during dialysis is relatively insensitive to the distributions of blood flow between compartments for Q_H<0.5 l/min or Q_H>4.5 l/min where Q_H denotes the blood flow to the high flow compartment. This simulation suggests that the inclusion of exercise during dialysis may be of limited utility in increasing solute removal during dialysis