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where C is the concentration [mol/m 3]; t is the time [s]; K is the clearance [m 3 /s]; V is the volume of distribution [m 3]; From the above definitions it follows that is the first derivative of concentration with respect to time, i.e. the change in concentration with time.
Kt/V and standardized Kt/V are not the same. Kt/V is a ratio of the pre- and post-dialysis urea concentrations. Standardized Kt/V is an equivalent clearance defined by the initial urea concentration (compare equation 8 and equation 10).
Both of these factors make the actual post-dialysis serum urea level higher than expected, and the URR lower than expected, when the extremely simplified equation above, is used. A more accurate relationship between URR and Kt/V can be derived by single-pool, variable volume urea kinetic modeling. A simplified estimating equation also can be ...
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.
A physiologic interpretation of clearance (at steady-state) is that clearance is a ratio of the mass generation and blood (or plasma) concentration. Its definition follows from the differential equation that describes exponential decay and is used to model kidney function and hemodialysis machine function:
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Hemofiltration is sometimes used in combination with hemodialysis, when it is termed hemodiafiltration. Blood is pumped through the blood compartment of a high flux dialyzer, and a high rate of ultrafiltration is used, so there is a high rate of movement of water and solutes from blood to dialysate that must be replaced by substitution fluid that is infused directly into the blood line.
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