Prof. Ahmad Taher Azar :: Publications:

One of the more useful techniques in the field of chronic dialysis support is the ability of defining a delivered dialysis dose. This has been traditionally accomplished using urea kinetic modeling either via direct dialysis quantification or using formulae or urea reductions to derive a specific urea removal rate in the chronic dialysis population. The application of urea kinetic analysis to hemodialysis has become more popular since completion of the U.S. National Cooperative Dialysis Study (NCDS) in 1980 [1]. Several studies have suggested that the dialysis dose delivered to many hemodialysis patients was less than that recommended by the NCDS [2]. The dose of dialysis and malnutrition are considered to play the major role in determining the clinical outcome in hemodialysis patients, and they have been shown to be associated with increased morbidity and mortality in end-stage renal disease (ESRD) patient population [3-11]. Increased removal of small molecular weight solute is associated with decreased morbidity. Additionally, some data suggest an association between improved survival and better nutritional status. It has been suggested that there is a potential link between dose of dialysis and nutritional status, since higher dialysis dose may improve appetite and increase both protein intake and urea generation rate. So that this research developing a new system to increase the achievement of adequate hemodialysis to a level consistent with or higher than National adequacy statistics, in order to reduce the morbidity rate of the hemodialysis patient, by building a system dynamics model that analyzing the dynamic implications of implementing adequate hemodialysis dose.