A Regional Blood Flow Model for Glucose and Insulin Kinetics During Hemodialysis
| Autor: | Jacek Waniewski, Magda Galach, Karl Thomaseth, Daniel Schneditz |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Blood Glucose
medicine.medical_treatment insulin blood level Bolus (medicine) Blood flow modeling diabetic patient Fluid management blood flow insulin release glucose systemic circulation clinical article hemodialysis Chemistry Insulin secretion adult Models Cardiovascular Model parameters article General Medicine insulin clearance Insulin kinetics aged glucose utilization female priority journal ultrafiltration Hemodialysis insulin extracorporeal circulation medicine.medical_specialty brain Biomedical Engineering Biophysics Bioengineering Hemodialyzers liver insulin dependent diabetes mellitus Extracorporeal fluid therapy Biomaterials Glucose concentration male Renal Dialysis Internal medicine Mole medicine Humans controlled study human distribution volume Distribution Volume parameters Insulin Hemodynamics glucose transport hemodialysis patient Blood flow Extracorporeal systems Kinetics Lakes glucose blood level Endocrinology Regional Blood Flow Dialysis |
| Zdroj: | ASAIO journal (1992) 59 (2013): 627–635. doi:10.1097/MAT.0000436714.72752.13 info:cnr-pdr/source/autori:Schneditz D., Galach M., Thomaseth K., Waniewski J./titolo:A regional blood flow model for glucose and insulin kinetics during hemodialysis/doi:10.1097%2FMAT.0000436714.72752.13/rivista:ASAIO journal (1992)/anno:2013/pagina_da:627/pagina_a:635/intervallo_pagine:627–635/volume:59 |
| ISSN: | 1058-2916 |
| DOI: | 10.1097/mat.0000436714.72752.13 |
| Popis: | The distribution and elimination of a bolus of glucose injected during hemodialysis (HD) was examined using a distributed double-pool regional blood flow model. Intracorporeal glucose disposal was assumed as insulin-independent (λ) in the central high-flow compartment comprising blood, brain, and internal organs, including pancreatic insulin secretion (a, C1) and hepatic insulin clearance (α). Insulin-dependent (γ) glucose utilization was allocated to the low-flow system comprising muscle, skin, and bone. This model was compared with a compact single-pool model using the same model parameters except for the distribution volume (V). Six parameters (C1, a, α, λ, γ, and V) were identified from data obtained in seven nondiabetic patients (59-115 kg). The fraction Fd of glucose removed by HD significantly (p < 0.05) correlated with baseline glucose concentration Cg,0 (5.561 ± 0.646 mmol/L; r = 0.535), extracorporeal clearance Kg (0.137 ± 0.024 L/min; r = 0.537), a (0.278 ± 0.095 L/mmol, r = -0.586), and λ (0.099 ± 0.078 L/min, r = -0.587). V was much larger in the double-compartment (17.8 ± 5.1 L) than in the single-compartment model (10.0 ± 3.0 L). The modeled glucose compartment volumes could be of interest for fluid management in HD patients. The use of extracorporeal glucose disposal to detect impaired glucose utilization (a, λ) remains to be validated in diabetic HD patients. |
| Databáze: | OpenAIRE |
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