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Hemodialysis

Hemodialysis or 'artificial kidney' therapy is used in renal failure to remove toxic waste material normally removed by the kidneys, from the patient's blood. In the procedure blood is diverted externally and allowed to flow across a semi-permeable membrane that is bathed with an aqueous isotonic solution. Small molecules including nitrogenous waste products and some drugs will diffuse from the blood, thus these compounds will be eliminated. Therefore in patients with kidney failure, hemodialysis may be an important route of drug elimination.

This technique is particularly important with drugs which:-

1) have good water solubility;
2) are not tightly bound to plasma protein;
3) are smaller (< 500) molecular weight; and
4) have a small apparent volume of distribution.

Conversely drugs which are tightly bound or extensively stored or distributed into tissues are only poorly removed by this route, or process.

A simulation of drug concentration with and without dialysis is shown in Figure 27.3.1.

Figure 27.3.1 Drug Concentration during and after Dialysis

These data were simulation using a one compartment model using Boomer (Macintosh, UNIX, and DOS .BAT files). Maybe you could try changing this to a two-compartment model and seeing what happens.

References

Shargel, L. and Yu, A.B.C. 1999 "Applied Biopharmaceutics and Pharmacokinetics", 4th ed., Appleton-Century-Crofts, Norwalk, CT, page 556, table 18.6

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