Frontiers in hemodialysis: Solutions and implications of mathematical models for bicarbonate restoring. (July 2019)

• Record Type: Journal Article
• Authors: Marano, Stefano; Marano, Marco
• Is Part Of: Biomedical signal processing and control. Volume 52(2019)
• Page Start: 321
• Page End: 329
• Publication Date: 2019-07
• Subjects: Mathematical model of hemodialysis -- Signal processing -- Acid–base balance -- Kidney disease -- Patient-centered therapy; Signal processing -- Periodicals; Biomedical engineering -- Periodicals; Signal Processing, Computer-Assisted -- Periodicals; Image Processing, Computer-Assisted -- Periodicals; Biomedical Engineering -- Periodicals; 610.28
• DOI: 10.1016/j.bspc.2019.02.029
• Languages: English
• ISSNs: 1746-8094

Abstract

Abstract: Acid–base correction is one main goal of hemodialysis therapy, some aspects of which are not yet well understood. This work considers a novel mathematical model of the patients' response to the rapid addition of base, providing closed-form analytical expressions for the bicarbonate concentration in the patient blood versus the time on dialysis, in function of the main physiological/clinical parameters. A signal processing model of the dialysis is proposed, in which the metabolic processes are represented by a combination of first-order linear systems with input step-signals that correspond to the external stimuli. The model sheds a light on important features of the therapy, highlighting the main medical implications, and revealing new challenges. With current dialysis protocols, it is shown that the base added actually decreases during the last two-thirds of the therapy, and the net amount of bicarbonate in the patient blood does not reach a steady-state value. Elaborating on the mathematical model, more sophisticated clinical protocols are suggested to counteract the potentially maladaptive patient response to treatment.