The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Physiol Rep. 2023 Dec;11(24):e15899. doi: 10.14814/phy2.15899.
In-depth understanding of intra- and postdialytic phosphate kinetics is important to adjust treatment regimens in hemodialysis. We aimed to modify and validate a three-compartment phosphate kinetic model to individual patient data and assess the temporal robustness. Intradialytic phosphate samples were collected from the plasma and dialysate of 12 patients during two treatments (HD1 and HD2). 2-h postdialytic plasma samples were collected in four of the patients. First, the model was fitted to HD1 samples from each patient to estimate the mass transfer coefficients. Second, the best fitted model in each patient case was validated on HD2 samples. The best model fits were determined from the coefficient of determination (R ) values. When fitted to intradialytic samples only, the median (interquartile range) R values were 0.985 (0.959-0.997) and 0.992 (0.984-0.994) for HD1 and HD2, respectively. When fitted to both intra- and postdialytic samples, the results were 0.882 (0.838-0.929) and 0.963 (0.951-0.976) for HD1 and HD2, respectively. Eight patients demonstrated a higher R value for HD2 than for HD1. The model seems promising to predict individual plasma phosphate in hemodialysis patients. The results also show good temporal robustness of the model. Further modifications and validation on a larger sample are needed.
深入了解透析内和透析后磷动力学对于调整血液透析治疗方案非常重要。我们旨在修改和验证一个三房室磷动力学模型，以适应个体患者的数据，并评估其时间稳健性。在两次治疗（HD1 和 HD2）期间，从 12 名患者的血浆和透析液中采集了透析内磷样本。在其中 4 名患者中，采集了透析后 2 小时的血浆样本。首先，将模型拟合到每位患者的 HD1 样本中，以估计质量转移系数。其次，在每位患者的 HD2 样本上验证最佳拟合模型。最佳模型拟合是通过决定系数（R ）值确定的。仅当拟合透析内样本时，HD1 和 HD2 的中位数（四分位距）R 值分别为 0.985（0.959-0.997）和 0.992（0.984-0.994）。当拟合透析内和透析后样本时，结果分别为 0.882（0.838-0.929）和 0.963（0.951-0.976），用于 HD1 和 HD2。8 名患者的 HD2 比 HD1 的 R 值更高。该模型有望预测血液透析患者的个体血浆磷。结果还表明模型具有良好的时间稳健性。需要进一步对更大的样本进行修改和验证。
