科研之友
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摘要
The distribution and elimination of a bolus of glucose injected during hemodialysis (HD) was examined using a distributed double-pool regional blood flow model. Intracorporeal glucose disposal was assumed as insulin-independent () in the central high-flow compartment comprising blood, brain, and internal organs, including pancreatic insulin secretion (a, C-1) and hepatic insulin clearance (). Insulin-dependent () glucose utilization was allocated to the low-flow system comprising muscle, skin, and bone. This model was compared with a compact single-pool model using the same model parameters except for the distribution volume (V). Six parameters (C-1, a, , , , and V) were identified from data obtained in seven nondiabetic patients (59-115 kg). The fraction F-d of glucose removed by HD significantly (p %26lt; 0.05) correlated with baseline glucose concentration C-g,C-0 (5.561 +/- 0.646 mmol/L; r = 0.535), extracorporeal clearance K-g (0.137 +/- 0.024 L/min; r = 0.537), a (0.278 +/- 0.095 L/mmol, r = -0.586), and (0.099 +/- 0.078 L/min, r = -0.587). V was much larger in the double-compartment (17.8 +/- 5.1 L) than in the single-compartment model (10.0 +/- 3.0 L). The modeled glucose compartment volumes could be of interest for fluid management in HD patients. The use of extracorporeal glucose disposal to detect impaired glucose utilization (a, ) remains to be validated in diabetic HD patients.
- 出版日期2013-12
