Please use this identifier to cite or link to this item: http://scholarbank.nus.edu.sg/handle/10635/90662
Title: Optimal intra-dialytic exercise protocol for improving the toxin removal in hemodialysis patients
Authors: Ahmad, Y.
Maheshwari, V.
Rangaiah, G.P.
Leong, T.L.W.
Samavedham, L. 
Keywords: Cardiac output
Creatinine rebound
Da-rbf model
Hemodiafiltration
Inter-compartmental clearance
Intra-dialytic exercise
Urea rebound
Issue Date: 2012
Citation: Ahmad, Y.,Maheshwari, V.,Rangaiah, G.P.,Leong, T.L.W.,Samavedham, L. (2012). Optimal intra-dialytic exercise protocol for improving the toxin removal in hemodialysis patients. i-CREATe 2012 - 6th International Convention on Rehabilitation Engineering and Assistive Technology : -. ScholarBank@NUS Repository.
Abstract: In this paper, we present the simulation studies to illustrate the benefits of optimal intra-dialytic exercise to improve the toxin removal using the diffusion-adjusted regional blood flow (DA-RBF) model developed by Schneditz et al. To optimize the exercise effect, two exercise-related parameters, i.e. the inter-compartmental mass transfer coefficient (KC), cardiac output (QC), and time of implementation for 3 bouts of exercise (t 1, t2, and t3) were considered as decision variables. A control vector parameterization method was used to optimize a realistic intra-dialytic exercise profile. During exercise, QC and KC were allowed to vary between their nominal values and 100% and 400% increase, respectively. Initial simulation suggested that during exercise, QC and KC reaches their maximum permissible values, thus only timings of exercise implementation were considered as decision variables in optimization. Results from the simulation study reveal that during the 3 bouts of optimal intermittent exercise, remotely sequestered solutes can be removed from the low flow region. As such, more toxins are removed in the dialyzer which consistently results in a decrease in percentage rebound (indicator of increased toxin removal) during the post-dialysis period for both urea and creatinine.
Source Title: i-CREATe 2012 - 6th International Convention on Rehabilitation Engineering and Assistive Technology
URI: http://scholarbank.nus.edu.sg/handle/10635/90662
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