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    HEMODYALISIS

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    herzi rahmatul s
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    HEMODYALISIS

    Uploaded by

    herzi rahmatul s
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    Download as pptx, pdf, or txt
    24 views8 pages

    HEMODYALISIS

    Uploaded by

    herzi rahmatul s
    :O

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 8

    HEMODYALISIS

    Methods to Measure Hemodialysis


    Clereans
    The extraction ratio method measures
    the extraction of drug across the articial
    kidney by obtaining simultaneous blood
    samples on input (C in) and output (C
    out) side of the dialysis coil.

    The tubing carrying blood to and from


    the patient usually has injection ports
    that can be used as access points to get
    the necessary blood samples.

    (Bauer, 2008 : 76)


    The articial kidney extraction ratio (ER) can be computed
    using serum concentrations measured from the blood
    samples:
    ER =(C in Cout )/C in

    Blood ow from the hemodialysis machine (HDBF) is


    available as a continuous readout on the pump, and
    hemodialysis clearance (Cl hd ) can be computed by taking
    the product of the extraction ratio and blood ow
    parameters: Clhd = HDBF ER

    The advantage to this technique is that it is


    methodologically simple. The disadvantage is if the dialysis
    extraction ratio is low, serum concentration differences
    between Cin and Cout will be small and difcult for the drug
    assay to determine.
    (Bauer, 2008 : 76)
    Another method is to collect the waste
    dialysis uid used during the dialysis
    procedure, and measure several serum
    drug concentrations during the same time
    interval (Figure 3-15)

    (Bauer, 2008 : 77)


    The amount of drug eliminated in the dialysis uid (A dialysis ) is
    determined by multiplying the volume of dialysis uid ( V
    Dialysis), and the concentration of drug in the dialysis uid
    (Cdialysis):
    A Dialysis = V Dialysis C Dialysis.

    Hemodialysis clearance (Cl HD) is computed by dividing the


    amount of drug eliminated in the dialysis uid by the area under
    the serum concentration/time curve during the dialysis period
    (AUC dyalysis , calculated using the serum concentrations
    obtained during hemodialysis):
    Cl HD = A Dialysis /AUC Dialysis

    An advantage of this method is that it is determined using


    multiple serum concentrations and may be more accurate.

    Disadvantages include collection of a large volume of dialysis


    uid (~120 L) and the large number of serum concentrations
    needed to determine AUC dialysis
    (Bauer, 2008 : 77)
    The nal method is to collect all the waste dialysis uid
    used during the dialysis period, and measure a single
    serum drug concentration at the midpoint of the
    procedure.
    Hemodialysis clearance (Cl HD ) can be computed using
    the following equation:
    Cl HD = (C Dialysis V Dialysis )/(C Serum T HD Dialysis)

    C Dialysis is the drug concentration in the dialysis uid,


    V Dialysis is the volume of dialysis uid,
    C serum is the drug serum concentration, and
    T Dialysis is the duration of the hemodialysis procedure

    An advantage of this technique is that it requires only one


    serum concentration
    The chief disadvantage is that all dialysis uid used during
    hemodialysis must(Bauer,
    be collected.
    2008 : 77)
    DAFTAR PUSTAKA
    Bauer, Larry A. 2008. APPLIED CLINICAL
    PHARMACOKINETICS. USA : Mc Graw Hill
    Medicine.

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