Czerwin Benjamin J, Patel Sandip, Chiofolo Caitlyn M, Yuan Jiayao, Chbat Nicolas W
Columbia University New York NY 10027 USA.
Quadrus Medical Technologies New York NY 10001 USA.
IEEE Open J Eng Med Biol. 2020 Nov 6;2:1-10. doi: 10.1109/OJEMB.2020.3036547. eCollection 2021.
We describe the relationship between mean arterial pressure (MAP) and glomerular filtration rate (GFR) since therapies affecting MAP can have large effects on kidney function. We developed a closed-loop, steady-state mechanistic model of the human kidney with a reduced parameter set estimated from measurements. The model was first validated against literature models. Further, GFR was validated against intensive care patient data (root mean squared error (RMSE) 13.5 mL/min) and against hypertensive patients receiving sodium nitroprusside (SNP) (RMSE less than 5 mL/min). A sensitivity analysis of the model reinforced the fact that vascular resistance is inversely related to GFR and showed that changes to either vascular resistance or renal autoregulation cause a significant change in sodium concentration in the descending limb of Henle. This model can be used to determine the impact of MAP on GFR and overall kidney health. The modeling framework lends itself to personalization of the model to a specific human.
由于影响平均动脉压（MAP）的治疗方法可能对肾功能产生重大影响，我们描述了平均动脉压与肾小球滤过率（GFR）之间的关系。我们开发了一个具有闭环、稳态机制的人体肾脏模型，并根据测量值估计了一组简化参数。该模型首先针对文献模型进行了验证。此外，还针对重症监护患者数据（均方根误差（RMSE）为13.5 mL/min）以及接受硝普钠（SNP）治疗的高血压患者进行了GFR验证（RMSE小于5 mL/min）。该模型的敏感性分析强化了血管阻力与GFR呈负相关这一事实，并表明血管阻力或肾自动调节的变化会导致亨氏袢降支中钠浓度发生显著变化。该模型可用于确定MAP对GFR和整体肾脏健康的影响。该建模框架有助于将模型个性化至特定个体。
