Principles and Biophysics of Dialysis

Intermittent dialysis therapy is used in chronic uremia to re-establish body water solute concentrations that cannot be achieved by the natural organ. In this sense, the dialyzer becomes an artificial kidney and it is through the transport of substances by this device that chemical and biophysical control consistent with continued survival is achieved. This chapter is organized as shown in Figure 1 and consists of two basic lines of development: 1. Consideration of the dialyzer and its operating principles 2. Application of mass balance principles to various solute systems and the effect of dialyzer use on solute control during intermittent dialysis therapy

[1]  J. Sargent.  Assessing the Utility and Improving the Effectiveness of Nutritional Support , 1986 .

[2]  W. Schwartz,et al.  The internal distribution of hydrogen ions with varying degrees of metabolic acidosis. , 1957, The Journal of clinical investigation.

[3]  E G Lowrie,et al.  THE UREA REDUCTION RATIO (URR). A SIMPLE METHOD FOR EVALUATING HEMODIALYSIS TREATMENT , 1992 .

[4]  G. Mayer,et al.  β2-MICROGLOBULIN AND HAEMODIALYSIS , 1987, The Lancet.

[5]  Gotch Fa,et al.  Precise control of minimal heparinization for high bleeding risk hemodialysis. , 1977 .

[6]  L L Hench,et al.  Direct chemical bond of bioactive glass-ceramic materials to bone and muscle. , 1973, Journal of biomedical materials research.

[7]  S. Nakagawa.  Multifactorial evaluation of hemofiltration therapy in comparison with conventional hemodialysis. , 1980, Artificial organs.

[8]  B. Scribner,et al.  The genesis of the square meter-hour hypothesis. , 1971, Transactions - American Society for Artificial Internal Organs.

[9]  J. Delmez,et al.  Severe dialyzer dysfunction undetectable by standard reprocessing validation tests. , 1989, Kidney international.

[10]  E. Schmidt,et al.  Plasma amino acids and ether-soluble phenols in uremia. , 1950, American journal of clinical pathology.

[11]  L. W. Statius van Eps,et al.  β2-microglobulin: Its significance in the evaluation of renal function , 1987 .

[12]  T. H. Frost,et al.  Kinetics of hemodialysis: a theoretical study of the removal of solutes in chronic renal failure compared to normal health. , 1977, Kidney international.

[13]  R. Redheffer,et al.  Mathematics of Physics and Modern Engineering , 1960 .

[14]  C. Kleeman,et al.  Use of a balanced low-protein diet in chronic renal failure. , 1967, JAMA.

[15]  N. Laird,et al.  Protocol for the National Cooperative Dialysis Study. , 1983, Kidney international. Supplement.

[16]  M. G. Cogan,et al.  Prevention of prednisone-induced negative nitrogen balance. Effect of dietary modification on urea generation rate in patients on hemodialysis receiving high-dose glucocorticoids. , 1981, Annals of internal medicine.

[17]  J. Miller,et al.  Chronic progressive renal disease: rate of change of serum creatinine concentration. , 1977, Kidney international.

[18]  J. Kopple,et al.  Nitrogen and urea metabolism during continuous ambulatory peritoneal dialysis. , 1981, Kidney international.

[19]  J. Cook,et al.  Decreased postdialysis fatigue with increased dialysate sodium concentration. , 1978, Proceedings of the Clinical Dialysis and Transplant Forum.

[20]  W. Schwartz,et al.  The disposition of acid administered to sodium-depleted subjects: the renal response and the role of the whole body buffers. , 1954, The Journal of clinical investigation.

[21]  C Basile,et al.  Percent reduction in blood urea concentration during dialysis estimates Kt/V in a simple and accurate way. , 1990, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[22]  S. Giovannetti,et al.  A LOW-NITROGEN DIET WITH PROTEINS OF HIGH BIOLOGICAL VALUE FOR SEVERE CHRONIC URAEMIA. , 1964, Lancet.

[23]  F. Gotch,et al.  Theoretical considerations on molecular transport in dialysis and sorbent therapy for uremia. , 1976, Journal of dialysis.

[24]  J. Sargent,et al.  Shortfalls in the delivery of dialysis. , 1990, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[25]  C. Flear,et al.  Solute and water exchanges between cells and extracellular fluids in health and disturbances after trauma. , 1980, JPEN. Journal of parenteral and enteral nutrition.

[26]  G. Berlyne,et al.  THE TREATMENT OF CHRONIC RENAL FAILURE BY A MODIFIED GIOVANNETTI DIET. , 1965, The Quarterly journal of medicine.

[27]  F. G. Donnan,et al.  The Theory of Membrane Equilibria. , 1924 .

[28]  P. Fürst,et al.  The influence of dialysis fluid composition on the blood pressure response during dialysis. , 1978, Clinical nephrology.

[29]  J. Letteri,et al.  Respiratory gas exchange during hemodialysis. , 1972, Proceedings of the Clinical Dialysis and Transplant Forum.

[30]  B. Frangione,et al.  Polymerization of intact beta 2-microglobulin in tissue causes amyloidosis in patients on chronic hemodialysis. , 1986, Proceedings of the National Academy of Sciences of the United States of America.

[31]  P. Jungers,et al.  Neuropathy and "middle" molecule toxins. , 1975, Kidney international. Supplement.

[32]  E G Lowrie,et al.  Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. , 1990, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[33]  W. Henrich,et al.  Role of osmolality in blood pressure stability after dialysis and ultrafiltration. , 1980, Kidney international.

[34]  J. Adamson,et al.  Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. Results of a combined phase I and II clinical trial. , 1987, The New England journal of medicine.

[35]  R. Mertelsmann,et al.  Abnormally high concentrations of beta 2 microglobulin in acquired immunodeficiency syndrome (AIDS) patients. , 1983, Clinical chemistry.

[36]  N. Laird,et al.  Effect of the hemodialysis prescription of patient morbidity: report from the National Cooperative Dialysis Study. , 1981, The New England journal of medicine.

[37]  Moncrief Jw,et al.  The consequences of physiological resistances on metabolite removal from the patient-artifical kidney system. , 1975 .

[38]  R. Maclennan,et al.  DIETARY FIBRE, TRANSIT-TIME, FÆCAL BACTERIA, STEROIDS, AND COLON CANCER IN TWO SCANDINAVIAN POPULATIONS Report from the International Agency for Research on Cancer Intestinal Microecology Group , 1977, The Lancet.

[39]  F. Gotch,et al.  Nitrogen balance during intermittent dialysis therapy of uremia. , 1978, Kidney international.

[40]  W. Summerskill,et al.  Transport of urea and ammonia production in the human colon. , 1971, Lancet.

[41]  P. Fürst,et al.  Uremic middle molecules exist and are biologically active. , 1979, Clinical nephrology.

[42]  D. Cocchi,et al.  THE PROLACTINOMA PROBLEM , 1980, The Lancet.

[43]  K. Hara,et al.  Amyloid deposition in systemic organs in long-term hemodialysis patients. , 1987, Clinical Nephrology.

[44]  A. Hull,et al.  Transcellular creatinine disequilibrium and its significance in hemodialysis. , 1974, Nephron.

[45]  W. Mitch,et al.  A proposed mechanism for reduced creatinine excretion in severe chronic renal failure. , 1978, Nephron.

[46]  Dedrick Rl,et al.  Pharmacokinetic and pharmacodynamic considerations for chronic hemodialysis. , 1975, Kidney international. Supplement.

[47]  Michaels As,et al.  Operating parameters and performance criteria for hemodialyzers and other membrane-separation devices. , 1966 .

[48]  F. Gotch,et al.  Comparative treatment time with Kiil, Gambro, and Cordis-Dow kidneys. , 1973, Proceedings of the Clinical Dialysis and Transplant Forum.

[49]  K. Koch,et al.  Differing haemodynamic stability due to differing sympathetic response: comparison of ultrafiltration, haemodialysis and haemofiltration. , 1980, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[50]  F. Gotch,et al.  Preliminary clinical results with sodium-volume modeling of hemodialysis therapy. , 1980, Proceedings of the Clinical Dialysis and Transplant Forum.

[51]  Messner Rp.  Beta 2-microglobulin: an old molecule assumes a new look. , 1984, The Journal of laboratory and clinical medicine.

[52]  S. Steinberg,et al.  Factors in the dialysis regimen which contribute to alterations in the abnormalities of uremia. , 1976, Kidney international.

[53]  M. Weiner,et al.  Acid-base changes and acetate metabolism during routine and high-efficiency hemodialysis in children. , 1981 .

[54]  F. Gotch,et al.  Studies on the molecular etiology of uremia. , 1975, Kidney international. Supplement.

[55]  H. Krebs.  The biochemical lesion in ketosis. , 1961, Archives of internal medicine.

[56]  D. Gallina,et al.  Urea excretion in adult humans with varying degrees of kidney malfunction fed milk, egg or an amino acid mixture: assessment of nitrogen balance. , 1973, The Journal of nutrition.

[57]  E. Klein,et al.  Evaluation of two pool model for prediciting serum creatinine levels during intra- and inter-dialytic periods. , 1975, Transactions - American Society for Artificial Internal Organs.

[58]  N. Feldman,et al.  Arterial oxygenation during hemodialysis. , 1977, The New England journal of medicine.

[59]  J. Chazan,et al.  Severity of metabolic acidosis as a determinant of bicarbonate requirements. , 1973, The New England journal of medicine.

[60]  H. Christensen.  General concepts of neutrality regulation. , 1962, American journal of surgery.

[61]  P. Olsson,et al.  The elimination from plasma of intravenous heparin. An experimental study on dogs and humans. , 2009, Acta medica Scandinavica.

[62]  E. Streicher,et al.  Clinical experience in hemofiltration , 1980, International Journal of Artificial Organs.

[63]  K. Koch,et al.  Hemodialysis / hemofiltration: A report of a controlled cross-over study , 1980, The International journal of artificial organs.

[64]  Schreiner Ge.  The search for the uremic toxin(s). , 1975 .

[65]  N. Laird,et al.  Modeling success or failure of dialysis therapy: the National Cooperative Dialysis Study. , 1983, Kidney international. Supplement.

[66]  J. Ladenson.  Direct potentiometric analysis of sodium and potassium in human plasma: evidence for electrolyte interaction with a nonprotein, protein-associated substance(s). , 1977, The Journal of laboratory and clinical medicine.

[67]  J. Revillard,et al.  Plasma β2, Microglobulin Turnover in Renal Insufficiency , 1980 .

[68]  C. Tisher,et al.  Lanthanum permeability of tight junctions along the collecting duct of the rat. , 1975, Kidney International.

[69]  James D. Jones,et al.  Creatinine metabolism in humans with decreased renal function: creatinine deficit. , 1974, Clinical chemistry.

[70]  E. Quellhorst,et al.  Response of the vascular system to different modifications of haemofiltration and haemodialysis. , 1980, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[71]  P. Richards,et al.  UREA METABOLISM IN AN AZOTÆMIC WOMAN WITH NORMAL RENAL FUNCTION , 1975, The Lancet.

[72]  Scribner Bh,et al.  Evidence for toxins of "middle" molecular weight. , 1975 .

[73]  H. Horowitz.  Uremic toxins and platelet function. , 1970, Archives of internal medicine.

[74]  J. Boudet,et al.  Characterization of a 1100-1300 MW uremic neurotoxin. , 1976, Transactions - American Society for Artificial Internal Organs.

[75]  F. Plum.  Handbook of Physiology. , 1960 .

[76]  F. Gotch,et al.  Individualized, quantified dialysis therapy of uremia. , 1974, Proceedings of the Clinical Dialysis and Transplant Forum.

[77]  R M Hakim,et al.  Effects of dose of dialysis on morbidity and mortality. , 1994, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[78]  R. Pitts,et al.  Neutralization of infused acid by nephrectomized dogs. , 1955, The Journal of clinical investigation.

[79]  D. Cuthbertson,et al.  The Metabolic Response to Injury and Its Nutritional Implications: Retrospect and Prospect , 1979 .

[80]  T. O'donnell,et al.  Energy metabolism and proteolysis in traumatized and septic man. , 1976, The Surgical clinics of North America.

[81]  R. Luke.  Uremia and the BUN. , 1981, The New England journal of medicine.

[82]  H. Vader,et al.  An evaluation of the Corning 902 direct potentiometric sodium/potassium analyser , 1982, The Journal of automatic chemistry.

[83]  P. Feig,et al.  Effect of potassium removal during hemodialysis on the plasma potassium concentration. , 1981, Nephron.

[84]  B. Wolfe,et al.  Substrate Interaction in Intravenous Feeding Comparative Effects of Carbohydrate and Fat on Amino Acid Utilization in Fasting Man , 1977, Annals of surgery.

[85]  Steffensen Ka.  Some determinations of the total body water in man by means of intravenous injections of urea. , 1947 .

[86]  I. Edelman,et al.  Interrelations between serum sodium concentration, serum osmolarity and total exchangeable sodium, total exchangeable potassium and total body water. , 1958, The Journal of clinical investigation.

[87]  P Keshaviah,et al.  Urea index and other predictors of hemodialysis patient survival. , 1994, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[88]  H. Gärtner,et al.  The kidney : structure and function , 1989 .

[89]  Homer W. Smith.  The Kidney: Structure and Function in Health and Disease , 1952 .

[90]  F. G. Heineken,et al.  Intercompartmental Fluid Shifts in Hemodialysis Patients , 1987 .

[91]  D. French.  The Schardinger dextrins. , 1957, Advances in carbohydrate chemistry.

[92]  P. Fürst,et al.  The effect of hemodialysis on endogenous middle molecules in uremic patients. , 1979, Clinical nephrology.

[93]  K. Nolph,et al.  Ultrafiltration: a mechanism for removal of intermediate molecular weight substances in coil dialyzers. , 1974, Kidney international.

[94]  J. Daugirdas.  Rapid methods of estimating Kt/V: three formulas compared. , 1990, ASAIO transactions.

[95]  Bell Rl,et al.  ANALOG SIMULATION OF THE PATIENT-ARTIFICIAL KIDNEY SYSTEM. , 1965 .

[96]  J. Letteri,et al.  HYPOVENTILATION AND HYPOXEMIA DURING HEMODIALYSIS: REFLEX RESPONSE TO REMOVAL OF CO2 ACROSS THE DIALYZER , 1977, Transactions - American Society for Artificial Internal Organs.

[97]  D. L. Fry,et al.  A COMPARISON OF IN VITRO AND IN VIVO SOLUTE‐PROTEIN BINDING INTERACTIONS IN NORMAL AND UREMIC SUBJECTS , 1972, Transactions - American Society for Artificial Internal Organs.

[98]  L. Hebert,et al.  Whole kidney volume/pressure relationships. , 1975, Kidney international.

[99]  P. A. Peterson,et al.  Turnover in humans of β2‐microglobulin: the constant chain of HLA‐antigens , 1971 .

[100]  F. Gotch,et al.  Urea kinetics: a guide to nutritional management of renal failure. , 1978, The American journal of clinical nutrition.

[101]  J. Bergström,et al.  NO CHANGE IN CORRECTED β2-MICROGLOBULIN CONCENTRATION AFTER CUPROPHANE HAEMODIALYSIS , 1987, The Lancet.

[102]  E. Kreyszig,et al.  Advanced Engineering Mathematics. , 1974 .

[103]  F. Gotch,et al.  Technical aspects of on-line proportioning of bicarbonate dialysate. , 1977, Proceedings of the Clinical Dialysis and Transplant Forum.

[104]  S W Smye,et al.  Paediatric haemodialysis: estimation of treatment efficiency in the presence of urea rebound. , 1992, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[105]  A. Mason,et al.  Effect of carbohydrate and fat intake on nitrogen excretion during total intravenous feeding. , 1977, Annals of surgery.

[106]  S. Shaldon,et al.  Vascular stability during hemofiltration. , 1980, Transactions - American Society for Artificial Internal Organs.

[107]  Michael P. Hlastala,et al.  Physiology of respiration , 1996 .

[108]  A. Guyton,et al.  Textbook of Medical Physiology , 1961 .

[109]  S. Shaldon,et al.  Vascular stability during high flux haemofiltration (HF). , 1979, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[110]  N. Brautbar,et al.  Successful application of sequential hemofiltration followed by diffusion dialysis with standard dialysis equipment. , 1978, Transactions - American Society for Artificial Internal Organs.

[111]  I. Danishefsky,et al.  Studies Made With Radioactive Heparin in Humans , 1960, Angiology.

[112]  J T Daugirdas,et al.  A regional blood circulation alternative to in-series two compartment urea kinetic modeling. , 1993, ASAIO journal.

[113]  G. Forbes,et al.  Urinary creatinine excretion and lean body mass. , 1976, The American journal of clinical nutrition.

[114]  K. Maeda,et al.  Hemodiafiltration with sodium concentration-controlled dialysate. , 1980, Artificial organs.

[115]  B. Scribner,et al.  HEMODIALYZER EVALUATION BY EXAMINATION OF SOLUTE MOLECULAR SPECTRA , 1972, Transactions - American Society for Artificial Internal Organs.

[116]  P. Farrell,et al.  Estimation of the permeability of cellulosic membranes from solute dimensions and diffusivities. , 1973, Journal of biomedical materials research.

[117]  D. Sethi,et al.  Synovial-fluid beta 2-microglobulin levels in dialysis arthropathy. , 1986, The New England journal of medicine.

[118]  H. Schedl,et al.  Creatinine excretion: variability and relationships to diet and body size. , 1962, The Journal of laboratory and clinical medicine.

[119]  G. Chisholm,et al.  Urea Distribution in the Body after Haemodialysis , 1962, British medical journal.

[120]  F. Gejyo,et al.  Beta 2-microglobulin: a new form of amyloid protein associated with chronic hemodialysis. , 1986 .

[121]  G. Barsotti,et al.  Dialysis of methylguanidine. , 1974, Kidney international.

[122]  L. Berman,et al.  The evaluation of hemodialyzers , 1958 .

[123]  F. Gotch,et al.  Measurement of the effective dialyzer Na diffusion gradient in vitro and in vivo. , 1985, Transactions - American Society for Artificial Internal Organs.

[124]  J. Hayslett,et al.  Increased large intestinal secretion of potassium in renal insufficiency. , 1977, Kidney international.

[125]  W. J. Johnson,et al.  Effects of urea loading in patients with far-advanced renal failure. , 1972, Mayo Clinic proceedings.

[126]  M. Walser,et al.  Urea metabolism in man. , 1959, The Journal of clinical investigation.

[127]  A. Grollman,et al.  Toxicity of urea and its role in the pathogenesis of uremia. , 1959, The Journal of clinical investigation.

[128]  H. Chmiel,et al.  Clinical experience with haemofiltration. , 1977, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[129]  F. Gotch,et al.  Clinical results of intermittent dialysis therapy (IDT) guided by ongoing kinetic analysis of urea metabolism. , 1976, Transactions - American Society for Artificial Internal Organs.

[130]  J. Bosch,et al.  Sodium fluxes during hemodialysis. , 1983, Transactions - American Society for Artificial Internal Organs.

[131]  J. Kopple,et al.  Controlled comparison of 20-g and 40-g protein diets in the treatment of chronic uremia. , 1968, The American journal of clinical nutrition.

[132]  E. Lewis,et al.  Respiratory gas exchange by high-efficiency hemodialyzers. , 1978, Nephron.

[133]  P. Farrell,et al.  Dialysis-induced catabolism. , 1980, The American journal of clinical nutrition.

[134]  B. Scribner,et al.  Quantitative description of dialysis treatment: a dialysis index. , 1975, Kidney international. Supplement.

[135]  B. D. Cohen,et al.  Guanidinosuccinic Acid in Uremia , 1970 .

[136]  V. Livolsi,et al.  Letter: Hepatoblastoma associated with an oral contraceptive. , 1974, Lancet.

[137]  Scribner Bh,et al.  Substitution of sodium acetate for sodium bicarbonate in the bath fluid for hemodialysis. , 1964 .

[138]  J A Sargent,et al.  A mechanistic analysis of the National Cooperative Dialysis Study (NCDS). , 1985, Kidney international.

[139]  K. Jindal,et al.  Percent reduction in blood urea concentration during hemodialysis (PRU). A simple and accurate method to estimate Kt/V urea. , 1987, ASAIO transactions.

[140]  J A Sargent,et al.  Mathematic modeling of dialysis therapy. , 1980, Kidney international. Supplement.

[141]  P. Fürst,et al.  Separation and characterization of uremic metabolites in biologic fluids: a screening approach to the definition of uremic toxins. , 1975, Kidney international. Supplement.

[142]  A. Erslev.  Erythropoietin coming of age. , 1987, The New England journal of medicine.

[143]  P. Altmeyer,et al.  Deposition of an amyloid-like substance as a possible complication of regular dialysis treatment. , 1983, Contributions to nephrology.

[144]  A. W. Hewlett,et al.  THE TOXIC EFFECTS OF UREA ON NORMAL INDIVIDUALS , 1916 .

[145]  I. Edelman,et al.  Anatomy of body water and electrolytes. , 1959, The American journal of medicine.

[146]  K. Nolph,et al.  Effects of ultrafiltration on dialysance in commercially available coils. , 1972, Kidney international.

[147]  H. Grey,et al.  Immunological identity of the small subunit of HL-A antigens and beta2-microglobulin and its turnover on the cell membrane. , 1974, Proceedings of the National Academy of Sciences of the United States of America.

[148]  G. Berlyne,et al.  Treatment of Chronic Renal Failure , 1966, Anglo-German medical review. Deutsch-englische medizinische Rundschau.

[149]  Robert F. Pitts,et al.  Physiology of the Kidney and Body Fluids , 1963 .

[150]  F. Lundquist.  Production and Utilization of Free Acetate in Man , 1962, Nature.

[151]  Lowrie Eg,et al.  Which mathematical model to study uremic toxicity? National Cooperative Dialysis Study. , 1982 .

[152]  A. Collins,et al.  Rapid high-efficiency bicarbonate hemodialysis. , 1986, ASAIO transactions.

[153]  S. C. Lin,et al.  Hemodialysis and plasma amino acid composition in chronic renal failure. , 1968, The American journal of clinical nutrition.

[154]  J. Jones,et al.  Implication of creatinine and gut flora in the uremic syndrome: induction of "creatininase" in colon contents of the rat by dietary creatinine. , 1972, Clinical chemistry.

[155]  B H Barbour,et al.  Clinical use of NISR 440 polycarbonate membrane for hemodialysis. , 1975, Transactions - American Society for Artificial Internal Organs.

[156]  K. Nolph,et al.  Factors affecting the composition of ultrafiltrate from hemodialysis coils. , 1970, Transactions - American Society for Artificial Internal Organs.

[157]  H. Tenckhoff,et al.  Experience with maintenance peritoneal dialysis in the home. , 1970, Transactions - American Society for Artificial Internal Organs.

[158]  B. Isaksson.  Urinary nitrogen output as a validity test in dietary surveys. , 1980, The American journal of clinical nutrition.

[159]  F. Gejyo,et al.  Serum levels of beta 2-microglobulin as a new form of amyloid protein in patients undergoing long-term hemodialysis. , 1986, The New England journal of medicine.

[160]  P. Keshaviah,et al.  The metabolic effects of hemodialysis with and without glucose in the dialysate. , 1978, The American journal of clinical nutrition.

[161]  A. V. Wolf,et al.  Artificial kidney function; kinetics of hemodialysis. , 1951, The Journal of clinical investigation.

[162]  Gotch Fa,et al.  The analysis of concentration dependence of uremic lesions in clinical studies. , 1975 .

[163]  S. Shaldon,et al.  Haemofiltration with sorbent regeneration of ultrafiltrate: first clinical experience in end stage renal disease. , 1978, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[164]  C. Young,et al.  Effect of sample protein concentration on results of analyses for sodium and potassium in serum. , 1980, Clinical chemistry.

[165]  R. Olson,et al.  Protein-calorie malnutrition , 1975 .

[166]  J. Kopple,et al.  Evaluation of chronic uremia. Importance of serum urea nitrogen, serum creatinine, and their ratio. , 1974, JAMA.

[167]  P. Feig,et al.  Disposition of intravenous potassium in anuric man: a kinetic analysis. , 1979, Kidney international.

[168]  Sargent Ja,et al.  Control of dialysis by a single-pool urea model: the National Cooperative Dialysis Study. , 1983 .

[169]  Barbara Silvestri,et al.  Physiology of Respiration 2nd ed , 1975 .

[170]  J W Ward,et al.  Neurotoxicity in uremia. , 1975, Kidney international. Supplement.

[171]  J. Estes.  THE KINETICS OF HEPARIN * , 1971, Annals of the New York Academy of Sciences.

[172]  B. Scribner,et al.  A central system for the continuous preparation and distribution of hemodialysis fluid. , 1964, Transactions - American Society for Artificial Internal Organs.

[173]  William B. Schwartz,et al.  The Effect of DOCA on Electrolyte Balance in Normal Man and its Relation to Sodium Chloride Intake * , 1952, The Yale journal of biology and medicine.

[174]  Gotch Fa,et al.  Mass balance: a quantitative guide to clinical nutritional therapy. I. The predialysis patient with renal disease. , 1979, Journal of the American Dietetic Association.

[175]  E. Lewis,et al.  Metabolic consequences of high mass-transfer hemodialysis. , 1977, Kidney international.

[176]  P. Keshaviah,et al.  ROLE OF DIALYSATE GLUCOSE IN PREVENTING GLUCONEOGENESIS DURING HEMODIALYSIS , 1977, Transactions - American Society for Artificial Internal Organs.

[177]  T. O'donnell,et al.  Energy Metabolism in Sepsis: Treatment Based on Different Patterns in Shock and High Output Stage , 1974, Annals of surgery.