Paediatric haemodialysis: estimation of treatment efficiency in the presence of urea rebound

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Abstract
The 2-pool urea kinetic model has been developed analytically and applied to the description of the observed increase in blood levels of urea following dialysis (urea rebound), assuming that the dialyser urea clearance K1, V2 respectively). Urea generation was also neglected. Measurements were made in a group of six children suffering from chronic renal failure. From the model X, the efficiency of dialysis, and the equilibrium urea concentration Cinfinity were estimated in the presence of urea rebound using a blood urea measurement taken 90 min following start of dialysis, in addition to the conventional samples taken immediately pre- and post-dialysis. The results indicated that Cinfinity was estimated to within 10% of the true equilibrium urea concentration. The error in the estimate of dialysis efficiency based on a single pool model was reduced by at least 50% using the model. The model may be applied clinically to the estimation of dialysis efficiency in the presence of significant urea rebound.