Kinetic Modeling Programs for Hemodialysis Adequacy Focusing on Urea, Creatinine, Phosphate, and Beta-2-Microglobulin.

Abstract

Here we describe six kinetic modeling programs that allow quantification of removal of urea, creatinine, phosphate, and beta-2-microglobulin. They can be used with asymmetric dialysis treatment schedules ranging from one to seven times per week. Once downloaded, the programs can be run locally from a personal computer without requiring connection to the internet. They have been designed to analyze solute removal in a single patient or in thousands of patients. Each program is contained in a single JavaScript-HTML text file, and all of the assumptions and equations used are easily accessible in uncompressed text format and are accompanied by comments and annotations. Inputs are in the form of comma-delimited files which can be imported from spreadsheets. Outputs appear in the form of web pages or as comma-delimited files that can be exported into spreadsheets for graphing and further analysis. This perspective focuses on describing the potential utility of these programs (two pertaining to urea, two to creatinine, one to phosphate, and one to beta-2-microglobulin) as well as two helper calculators, one that computes dialyzer mass transfer area coefficient for urea (K0A) from dialyzer specification chart urea clearance data, and another that can be used to calculate the phosphate binder equivalent dose.