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논문분류	춘계학술대회 초록집
제목	Comparison of Simulated Dialysis Efficacy and Actual Dialysis Efficacy of Hemodialysis and Pre-Dilution Online Hemodiafiltration Patients
저자	Tanaka Tomoyuki
출판정보	2026; 2026(1):
키워드	Dialysis efficacy, pre-online hemodiafiltration, Kt/V, python
초록	Objectives: In hemodialysis, the choice of dialyzer and settings, such as blood flow rate, significantly impact treatment effectiveness. A computer-programmed simulator that allows preliminary verification of treatment effects by adjusting blood volume, dialysate flow rate, dialysate duration, and dialyzer selection would be beneficial. However, no such simulator has been developed. Therefore, this study created a simulator to validate dialysis efficiency under different treatment conditions. Methods: A program was developed using Python to calculate the mass transfer coefficient (KoA), Clearance (CL sim) , Kt/V values(Kt/V sim), and post-dialysis blood urea nitrogen concentrations (BUN post sim) . The calculation uses published performance ratings of each dialyzer and hemodialysis treatment conditions. Kt/V values were calculated as CL sim times simulation time divided by distribution volume(60 % of Weight). Data was obtained from 65 patients at collaborating medical institutions( age: 70 ± 8.5 years, treatment method: hemodialysis and pre dilution hemodiafiltration, treatment duration: 3.9 ± 0.5 h, blood flow: 240 ± 30.5 ml/min, and dialysate flow: 590 ± 80 ml/min). The actual Kt/V values were calculated using the Shinzato formula (Kt/V act). The simulated values and actual values were compared using Bland-Altman plots. Results: Kt/V act was 1.3 ± 0.3 and Kt/Vsim was 1.3 ± 0.3. The difference between Kt/Vsim and Kt/V act was mean = 0.04 (SD = 0.17). Actual post BUN(BUN post act) was 17.8 ± 5.6mg/dl, and BUN post sim was 14.5±5.5 mg/dl. The difference between BUN post sim and BUN post act was mean = −3.26 mg/dL (SD = 2.9 mg/dL). Conclusion: The simulated Kt/V was higher than the actual Kt/V and the simulated post-dialysis BUN concentration was smaller than the actual value. Simulated values of hemodialysis efficacy tend to be overestimated.
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