Mathematical models for phosphate kinetics in patients on maintenance hemodialysis

Abstract In maintenance hemodialysis patients, efficient removal of phosphate during the hemodialysis session is crucial for the control of hyperphosphatemia and other frequent abnormalities of mineral metabolism. A mathematical model that integrates different distribution compartments and forms of...

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Main Authors: Jacek Waniewski, Malgorzata Debowska, Alicja Wojcik-Zaluska, Wojciech Zaluska, Bengt Lindholm
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-93443-1
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author Jacek Waniewski
Malgorzata Debowska
Alicja Wojcik-Zaluska
Wojciech Zaluska
Bengt Lindholm
author_facet Jacek Waniewski
Malgorzata Debowska
Alicja Wojcik-Zaluska
Wojciech Zaluska
Bengt Lindholm
author_sort Jacek Waniewski
collection DOAJ
description Abstract In maintenance hemodialysis patients, efficient removal of phosphate during the hemodialysis session is crucial for the control of hyperphosphatemia and other frequent abnormalities of mineral metabolism. A mathematical model that integrates different distribution compartments and forms of phosphate may provide deeper insight and elucidation of observed kinetics of phosphate levels in plasma. Three mathematical models were constructed to describe the kinetics of phosphate during a one-week cycle of three dialysis sessions. The models included the extracellular and intracellular compartments for phosphate ions, plasma and interstitial compartments for phosphate ions bound to protein, and a compartment for fast exchangeable phosphate ions, and differing by the presence or exclusion of the fast or the intracellular compartment. The models included also an intracellular store of phosphate that might be released at an increasing rate during dialysis sessions. The weekly kinetics of total phosphate levels in plasma predicted by the three models were similar and agreed with the clinical data. The inclusion of free phosphate ion and protein bound phosphate separately provided small but significant modifications of the predicted profiles. The time dependent release of phosphate from the intracellular store was critical for the correct description of phosphate kinetics in plasma. The hypothesis that a fast compartment and an intracellular store compartment separately or combined contribute significantly to the kinetics of total phosphate in plasma was shown to be compatible with clinical data.
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issn 2045-2322
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spelling doaj-art-bdefd7d84d694887a8e83ea42c3c3c312025-08-20T03:41:40ZengNature PortfolioScientific Reports2045-23222025-03-0115111210.1038/s41598-025-93443-1Mathematical models for phosphate kinetics in patients on maintenance hemodialysisJacek Waniewski0Malgorzata Debowska1Alicja Wojcik-Zaluska2Wojciech Zaluska3Bengt Lindholm4Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesNalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesDepartment of Clinical Physiotherapy, Medical University of LublinDepartment of Nephrology, Medical University of LublinRenal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetAbstract In maintenance hemodialysis patients, efficient removal of phosphate during the hemodialysis session is crucial for the control of hyperphosphatemia and other frequent abnormalities of mineral metabolism. A mathematical model that integrates different distribution compartments and forms of phosphate may provide deeper insight and elucidation of observed kinetics of phosphate levels in plasma. Three mathematical models were constructed to describe the kinetics of phosphate during a one-week cycle of three dialysis sessions. The models included the extracellular and intracellular compartments for phosphate ions, plasma and interstitial compartments for phosphate ions bound to protein, and a compartment for fast exchangeable phosphate ions, and differing by the presence or exclusion of the fast or the intracellular compartment. The models included also an intracellular store of phosphate that might be released at an increasing rate during dialysis sessions. The weekly kinetics of total phosphate levels in plasma predicted by the three models were similar and agreed with the clinical data. The inclusion of free phosphate ion and protein bound phosphate separately provided small but significant modifications of the predicted profiles. The time dependent release of phosphate from the intracellular store was critical for the correct description of phosphate kinetics in plasma. The hypothesis that a fast compartment and an intracellular store compartment separately or combined contribute significantly to the kinetics of total phosphate in plasma was shown to be compatible with clinical data.https://doi.org/10.1038/s41598-025-93443-1Chronic kidney diseaseMineral metabolismKinetics of hemodialysisIntracellular phosphate stores
spellingShingle Jacek Waniewski
Malgorzata Debowska
Alicja Wojcik-Zaluska
Wojciech Zaluska
Bengt Lindholm
Mathematical models for phosphate kinetics in patients on maintenance hemodialysis
Scientific Reports
Chronic kidney disease
Mineral metabolism
Kinetics of hemodialysis
Intracellular phosphate stores
title Mathematical models for phosphate kinetics in patients on maintenance hemodialysis
title_full Mathematical models for phosphate kinetics in patients on maintenance hemodialysis
title_fullStr Mathematical models for phosphate kinetics in patients on maintenance hemodialysis
title_full_unstemmed Mathematical models for phosphate kinetics in patients on maintenance hemodialysis
title_short Mathematical models for phosphate kinetics in patients on maintenance hemodialysis
title_sort mathematical models for phosphate kinetics in patients on maintenance hemodialysis
topic Chronic kidney disease
Mineral metabolism
Kinetics of hemodialysis
Intracellular phosphate stores
url https://doi.org/10.1038/s41598-025-93443-1
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AT wojciechzaluska mathematicalmodelsforphosphatekineticsinpatientsonmaintenancehemodialysis
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