Application of Individualized Bayesian Urea Kinetic Modeling to pediatric hemodialysis. 2010

Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
Laboratory for Applied PK/PD, Division of Clinical Pharmacology and Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. oljamc@mac.com

Incorporating urea rebound using equilibrated urea concentration (Ceq) after hemodialysis (HD) is essential for accurate assessment of HD efficiency. It is impractical to measure Ceq in clinical settings, and there are no recommended methodologies to predict Ceq in children. The objective of this work is to assess the ability of an Individualized Bayesian Urea Kinetic Model (IBKM) for predicting Ceq in children receiving HD. Developed based on adult HD data, the IBKM is a two-pool urea kinetic model that calculates Bayesian estimates of individual Ceq. Blood urea nitrogen (BUN) samples from 30 HD sessions in 13 children (age 12-18 years) were taken at pre-HD, immediately post-HD, and 60 minutes post-HD (Ceq). The IBKM and estimated population parameters from adult data were fitted to the observed data from children to predict individual Ceq using NONMEM VI software in comparison with observed Ceq (9.5 +/- 3.8 mmol/L), the average individual predicted Ceq was 9.4 +/- 3.8 mmol/L, with absolute individual prediction error of 6.2% +/- 4.4%. For a given dialysis goal and desired dialysis duration, the required blood flow rate and dialyzer size are predicted by IBKM and confirmed by the analysis data. This study suggests that the IBKM can be used in a pediatric HD setting and accurately predict Ceq in children using only pre-HD and immediately post-HD BUN.

UI MeSH Term Description Entries
D008297 Male Males
D010372 Pediatrics A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.
D001806 Blood Urea Nitrogen The urea concentration of the blood stated in terms of nitrogen content. Serum (plasma) urea nitrogen is approximately 12% higher than blood urea nitrogen concentration because of the greater protein content of red blood cells. Increases in blood or serum urea nitrogen are referred to as azotemia and may have prerenal, renal, or postrenal causes. (From Saunders Dictionary & Encyclopedia of Laboratory Medicine and Technology, 1984) BUN,Nitrogen, Blood Urea,Urea Nitrogen, Blood
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002985 Clinical Protocols Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy. Protocols, Clinical,Research Protocols, Clinical,Treatment Protocols,Clinical Protocol,Clinical Research Protocol,Clinical Research Protocols,Protocol, Clinical,Protocol, Clinical Research,Protocols, Clinical Research,Protocols, Treatment,Research Protocol, Clinical,Treatment Protocol
D004333 Drug Administration Routes The various ways of administering a drug or other chemical to a site in a patient or animal from where the chemical is absorbed into the blood and delivered to the target tissue. Administration Routes, Drug,Administration Route, Drug,Drug Administration Route,Route, Drug Administration,Routes, Drug Administration
D005260 Female Females
D005544 Forecasting The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology. Futurology,Projections and Predictions,Future,Predictions and Projections
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
March 1995, The International journal of artificial organs,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
April 2019, Hemodialysis international. International Symposium on Home Hemodialysis,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1994, Contributions to nephrology,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1990, Advances in peritoneal dialysis. Conference on Peritoneal Dialysis,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1977, Transactions - American Society for Artificial Internal Organs,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1991, Nephron,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1990, Medical decision making : an international journal of the Society for Medical Decision Making,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1995, Nephron,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
January 1994, Polskie Archiwum Medycyny Wewnetrznej,
Olivera Marsenic, and Liping Zhang, and Athena Zuppa, and Jeffrey S Barrett, and Marc Pfister
March 1989, Archivio italiano di urologia, nefrologia, andrologia : organo ufficiale dell'Associazione per la ricerca in urologia = Urological, nephrological, and andrological sciences,
Copied contents to your clipboard!