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Determinants of phosphorus mobilization during hemodialysis.

Abstract
Our recent work proposed a pseudo one-compartment model for describing intradialysis and postdialysis rebound kinetics of phosphorus. In this model, phosphorus is removed directly from a central distribution volume with the rate of phosphorus mobilization from a second, very large compartment proportional to the phosphorus mobilization clearance. Here, we evaluated factors of phosphorus mobilization clearance and postdialysis central distribution volume from 774 patients in the HEMO Study. Phosphorus mobilization clearance and postdialysis central distribution volume were 87 (65, 116) ml/min, median (interquartile range), and 9.4 (7.2, 12.0) liter, respectively. The phosphorus mobilization clearance was significantly higher for male patients than for female patients. Both the phosphorus mobilization clearance and the postdialysis central distribution volume were significantly associated with postdialysis body weight but negatively with the predialysis serum phosphorus concentration. The postdialysis central distribution volume was also significantly associated with age. Overall, the postdialysis central distribution volume was 13.6% of the postdialysis body weight. Thus, the phosphorus mobilization clearance during hemodialysis is higher when predialysis serum phosphorus concentration is low and higher in male patients than in female patients. The central distribution volume of phosphorus is a space approximating the extracellular fluid volume.
AuthorsJohn K Leypoldt, Baris U Agar, Alp Akonur, Audrey M Hutchcraft, Kenneth O Story, Bruce F Culleton
JournalKidney international (Kidney Int) Vol. 84 Issue 4 Pg. 841-8 (Oct 2013) ISSN: 1523-1755 [Electronic] United States
PMID23715125 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Phosphorus
Topics
  • Adult
  • Aged
  • Body Weight
  • Cross-Sectional Studies
  • Extracellular Fluid (metabolism)
  • Female
  • Humans
  • Kidney (metabolism)
  • Kidney Diseases (metabolism, therapy)
  • Linear Models
  • Male
  • Middle Aged
  • Models, Biological
  • Phosphorus (metabolism)
  • Renal Dialysis
  • Sex Factors

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