Mathematical modelling of thermal and circulatory effects during hemodialysis

R.P.J. Droog, B.R.M. Kingma, W.D. Marken Lichtenbelt, van, J.P. Kooman, F.M. Sande, van der, N.W. Levin, A.A. Steenhoven, van, A.J.H. Frijns

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
8 Downloads (Pure)

Abstract

Intradialytic hypotension (IDH) is one of the most common complications of hemodialysis (HD) treatment. The initiating factor of IDH is a decrease in blood volume which is related to an imbalance between ultrafiltration (UF) and refilling rate. Impaired reactivity of resistance and capacitance vessels in reaction to hypovolemia plays possibly a major role in the occurrence of IDH. These vessels also fulfill an important function in body temperature regulation. UF induced cutaneous vasoconstriction would result in a reduced surface heat loss and an increase in core temperature. To release body heat, skin blood flow (SBF) is increased at a later stage of the HD treatment, whereby possibly IDH can occur. Aim of the study is to develop a mathematical model which can provide insight into the impact of thermoregulatory processes on the cardiovascular system during HD treatment. The mathematical procedure has been created by coupling a thermo-physiological (TP) model with a cardiovascular (CV) model to study regulation mechanisms in the human body during HD+UF. Model simulations for isothermal vs. thermoneutral HD+UF were compared to measurement data of patients on chronic intermittent HD (n=13). Core temperature during simulated HD+UF sessions increased within the range of measurement data (0.23ºC vs. 0.32±0.41ºC). The model showed a decline in mean arterial pressure (MAP) of -7% for thermoneutral HD+UF versus -4% for isothermal HD+UF after 200 minutes during which relative blood volume (RBV) changed by -13%. In conclusion, simulation results of the combined model show possibilities for predicting circulatory and thermal responses during HD+UF.
Original languageEnglish
Pages (from-to)797-811
Number of pages15
JournalArtificial Organs
Volume36
Issue number9
DOIs
Publication statusPublished - 2012

Fingerprint Dive into the research topics of 'Mathematical modelling of thermal and circulatory effects during hemodialysis'. Together they form a unique fingerprint.

Cite this