Studies in Computational Intelligence
Editor-in-Chief
Prof. Janusz Kacprzyk
Systems Research Institute
Polish Academy of Sciences
ul. Newelska 6
01-447 Warsaw
Poland
E-mail: kacprzyk@ibspan.waw.pl
For further volumes:
http://www.springer.com/series/7092
404
Ahmad Taher Azar (Ed.)
Modeling and Control of
Dialysis Systems
Volume 1: Modeling Techniques of
Hemodialysis Systems
ABC
Editor
Ahmad Taher Azar, PhD, IEEE Member
Assistant Professor, Computer and Software Engineering Department,
Faculty of Engineering,
Misr University for Science & Technology (MUST),
6th of October City, Egypt.
Editor in Chief of International Journal Of System Dynamics Applications (IJSDA),
IGI-Global, USA.
Additional material to this book can be downloaded from http://extra.springer.com
ISSN 1860-949X
e-ISSN 1860-9503
ISBN 978-3-642-27457-2
e-ISBN 978-3-642-27458-9
DOI 10.1007/978-3-642-27458-9
Springer Heidelberg New York Dordrecht London
Library of Congress Control Number: 2011945321
c Springer-Verlag Berlin Heidelberg 2013
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While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any
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Springer is part of Springer Science+Business Media (www.springer.com)
Dedication
I dedicate this book to my wife, her endless prayers through days and
nights keep lighting me the way and without her patience, understanding
and support the completion of this work would not have been possible. To
my dearest, beautiful and extraordinary daughters Hla and Nadine to
whose love will always be an inspiration for me. I wish to dedicate this
book also, to my mother. She taught me to persevere and prepared me to
face challenges with faith and humility. She is a constant source of inspiration to my life. I always feel her presence used to urge me to strive to
achieve my goals in life. Also, to my sisters for their endless love,
patience, trust and sacrifices for me.
Preface
The primary purpose of the book is to facilitate education in the
increasingly important areas of dialysis. It is written as a textbook for a
course at the graduate or upper-division undergraduate level for biomedical
engineering students. The biomedical engineering is the inter marriage of
engineering and medicine. The need to effectively utilize high technology
equipment and systems in the dialysis field necessitates the expertise of
clinical engineers, hospital physicians and computer scientists. Hardly any
patient today would pass through a hospital or even a family physician’s
chamber without the use of this technology.
Although there is enough material in the text for nephrologists, nurses,
technicians and other members of the health care team resolve the myriad
of problems confronting the patients undergoing dialysis. The text is also
suitable for self study and for short, intensive courses of continuing
education. The authors include a senior consultant nephrologist with
considerable expertise in all aspects of dialysis. Advanced topics and
future challenges are addressed as well, with the researchers in the field in
mind. The introductory material, application oriented techniques, and case
studies should be particularly useful to practicing professionals.
While several books are available today that address the principles of
dialysis, none, unfortunately, provides the practicing knowledge engineer,
system analyst, and biomedical researchers with specific, practical
information about various modeling and control techniques in the field of
dialysis and their applications. The book discusses novel ideas and
provides a new insight into the studied topics. The book on this subject
will constitute an important contribution in the field of hemodialysis and
peritoneal dialysis.
The book is unique for its diversity in contents, clarity and precision of
presentation and the overall completeness of its chapters. Each chapter in
the book openes with a chapter outline, chapter objectives, key terms list
and chapter abstract. Each chapter ends with a conclusion and
bibliographic references related to the text. The book is basically broken
into two volumes with five parts. The first volume includes the first part of
the book from chapters 1–14 which covers overview of dialysis treatment
and urea kinetic modeling techniques. There are three treatment modalities
VIII
Preface
available for patients with chronic renal failure: hemodialysis (HD),
peritoneal dialysis (PD), and renal transplantation (RT). Although these
treatment modalities have proved to be life sustaining, patients with endstage renal disease (ESRD) continues to grow in the worldwide. The
incident population of patients with ESRD is increasing at approximately
6% each year. Kidney transplantation is considered the treatment of choice
for many people with severe chronic kidney disease because quality of life
and survival are often better than in people who use dialysis. Despite
assiduous efforts to utilize renal transplantation as a viable option for
potential recipients with ESRD, the donor organ shortage has been one of
the major barriers to kidney transplantation. Patients who are not
candidates for kidney transplantation or who must wait for a kidney can
usually be treated with either hemodialysis or peritoneal dialysis. Dialysis
prescription must ensure that an adequate amount of dialysis is delivered to
the patient. Numerous studies have shown a correlation between the
delivered dose of hemodialysis and patient morbidity and mortality.
Therefore, the delivered dose should be measured and monitored routinely
to ensure that the patient receives an adequate amount of dialysis. Urea
Kinetic Modeling (UKM) is beneficial because it assists clinicians in
individualizing dialysis prescriptions and provides the hemodialysis care
team with guidance about which specific parameters of the prescription to
modify to achieve the target hemodialysis dose. The presentation of these
chapters requires only a basic knowledge of linear algebra, differential
equations and probability theory.
The second volume of the book includes the remaining parts (from part 2
to part 5). The second part of the book from chapters 15–19 describes online
dialysis monitoring devices and continuous therapy. In the past few years,
several devices have been developed in the field of dialysis. These devices
obviate the need for blood sampling, minimize random measurement errors,
and allow a whole range of parameters to be calculated which are likely to
be of future clinical value. These new devices also may be coupled on-line
to a central database so that measured and calculated values can be recorded
without manual intervention, allowing almost instant information of clinical
value to the patient.
The third part of the book from Chapters 20–25 covers biofeedback
Systems and soft computing Techniques of dialysis. Biofeedback represents
the first step towards a ‘physiological’ HD system incorporating adaptive
and logic controls in order to achieve pre-set treatment targets and to ensure
delivery of the prescribed dialysis dose. Soft computing approaches in
decision making have become increasingly popular in many disciplines. Soft
computing concerns the use of theories of fuzzy logic, neural networks, and
evolutionary computing to solve real-world problems that cannot be
IX
Preface
satisfactorily solved using conventional crisp computing techniques. A novel
applications of soft computing techniques are discussed in this part of the
book. While sufficient theory of each technique is presented, it is offered in
a simplified manner for the benefit of the students.
The fourth part of the book from Chapters 26–30 covers the overview of
peritoneal dialysis and its modeling techniques.
Finally, the fifth part of the book has two chapters to cove the future
challenges and general guidelines of dialysis.
It is hoped that the book will be a very good compendium for almost all
readers — from students of undergraduate to postgraduate level and also
for researchers, professionals, etc. — who wish to enrich their knowledge
on dialysis systems’ principles and applications with a single book in the
best manner.
Solved Examples, Applications, and Implementation Case Studies
A vast array of illustrative examples, implementation case studies for a
variety of applications, end-of-chapter questions and problems are used
throughout the text. There are over 1000 questions in this textbook. The
basic goals of these case studies, examples and questions are as follows:
To help illustrate the theory.
To encourage good problem-solving skills.
To show how to apply the techniques.
To help illustrate design procedures in a concrete way.
To show what practical issues are encountered in the development
and implementation of dialysis systems.
To the Student
The best way to learn new material is by reading, thinking, and doing. This
text is designed to help you along the way by providing an overview and
objectives for each section, numerous worked- out examples, exercises and
self-test questions. Read each section of the text carefully and think about
what you have read. Sometimes you may need to read the section more
than once. Work through each example problem step by step before you
try the related problem that goes with the example. After the end of each
chapter, answer the essay questions and multiple choice questions. The
abundance of these questions is very useful for you to check your progress
and understanding as they require more systematic and in-depth thinking.
If you are able to solve the chapter questions for a given objective, you
have mastered that objective.
X
Preface
For Instructors
A. Instructor Solutions Manual
Fully worked-out solutions to end-of chapter questions and problems. So
you can check your work.
B. Possible Course Structures
The material in this textbook has been designed for a one-semester, twosemester, or three-quarter sequence depending on the needs and interests
of the instructor. The material in the book is suitable for a number of
courses at the undergraduate and graduate levels. Some possibilities are
given below.
Dialysis principles (senior undergraduate or introductory graduatelevel course): Chapters 1, 2, 3, 4, 5, 7, 9, 26, 27, 30, 31 and 32.
Modeling techniques of dialysis (senior undergraduate or graduatelevel course): Chapters 6, 8, 10, 11, 12, 13, 14, 19, 25, 28 and 29.
Online dialysis monitoring and continuous therapy (senior undergraduate or introductory graduate-level course): Chapters 15, 16,
17, 18, 19, 25.
Biofeedback Systems and Soft computing applications in dialysis
(senior undergraduate or graduate-level course): Chapters 20, 21,
22, 23, 24, and 25.
Principles of peritoneal dialysis and its modeling techniques
(senior undergraduate or graduate-level course): Chapters 26, 27,
28, 29, and 30.
Feedback on the Book
We are deeply indebted to the many instructors and students who have
offered positive feedback and suggestions for improvement. We are
delighted whenever we receive email from instructors and students who
use the book, even when they are pointing out an error we failed to catch
in the review process. We are also open to your suggestions on how to
improve the content, the pedagogy, and the presentation in this text by
emailing me at ahmad_t_azar@yahoo.com. We are privileged to have the
opportunity to impact the educational experience of the many thousands of
future engineers who will turn the pages of this text.
Preface
XI
Acknowledgements
My sincere thanks to all contributing authors of this book not only because
of their expertise in the science of medicine, but because they are
physicians who are able to translate and apply their scientific knowledge in
a practical way to allow for a systematic and evidence based plan of
therapy and treatment in the best interests of patients.
Special thanks go to our publisher, Springer-Verlag Berlin Heidelberg
and data processing team Prabu G., and Shenbagavadivu D. for their
valuable review during the publication process. Special thanks for the
tireless work of the series editor of Studies in Computational Intelligence,
Dr. Thomas Ditzinger.
Ahmad Taher Azar, PhD, IEEE Member
Assistant Professor, Computer and Software Engineering Department,
Faculty of Engineering, Misr University for Science & Technology (MUST),
6th of October City, Egypt.
Editor in Chief of International Journal Of System
Dynamics Applications (IJSDA),
IGI-Global, USA.
About the Editor
Dr. Ahmad Azar has received the M.Sc. degree (2006) in System Dynamics
and Ph.D degree (2009) in Adaptive Neuro-Fuzzy Systems from Faculty of
Engineering, Cairo University (Egypt). He is currently Assistant Professor,
Computer and Software Engineering Department, Faculty of Engineering,
Misr University for Science & Technology (MUST), Egypt. Dr. Ahmad
Azar has worked in the areas of System Dynamics, Intelligent Control, soft
computing and Modelling in Biomedicine and is the author of more than 40
papers in these subjects. He is an editor of four Books in the field of Fuzzy
logic systems and biomedical Engineering. Dr. Ahmad Azar is closely associated with several international journals as a reviewer. He serves as
international programme committee member in many international and peerreviewed conferences. He currently serves as the Editor of a lot of international journals. His biography was selected to appear in the 27th and 29th
Editions of Who's Who in the World, Marquis Who's Who, USA, 2010 and
2012, respectively. Dr Ahmad Azar is currently the Vice chair of IEEE
Computational Intelligence Society (CIS) Egypt Chapter and Vice President
Of Egypt System Dynamics Chapter. He is an Academic Member of IEEE
Systems, Man, and Cybernetics Society Technical Committee on Computational Collective Intelligence and also a member in KES Focus Group on
Agent and Multi-agent Systems. His reserach interests include: Control System Analysis, Systems Engineering, System Dynamics, Medical Robotics,
Process Control, Neural network, Fuzzy logic controllers, Neuro-Fuzzy systems, System thinking, Mathematical Modeling and Computer Simulation,
Statistical Analysis, Decision Making Analysis, Research Methodology,
Biofeedback systems, Monitoring and Controlling of Hemodialysis System.
Contents
Part 1: Overview of Dialysis Treatment and Modeling Techniques
1 Initiation of Dialysis ..............................................................................3
Ahmad Taher Azar, Alicja E. Grzegorzewska
1.1 Structure of Normal Kidneys ...........................................................4
1.2 Functions of Normal Kidney............................................................7
1.3 Renal Failure ..................................................................................14
1.4 Renal Replacement Therapy (RRT)...............................................22
1.5 Final Remarks and Conclusions.....................................................37
References..............................................................................................38
2 Measurement of Renal Function........................................................45
Ahmad Taher Azar
2.1 Stages of Chronic Kidney Disease................................................46
2.2 Measurement of Residual Renal Function ....................................47
2.3 Glomerular Filtration Rate in Children with Chronic
Kidney Disease..............................................................................73
2.4 Conclusion ....................................................................................81
References.............................................................................................82
3 Hemodialysis System...........................................................................99
Ahmad Taher Azar, Bernard Canuad
3.1 Principles of Dialysis ..................................................................100
3.2 Hemodialysis Machine................................................................116
3.3 Advanced Options for Hemodialysis Machines..........................148
3.4 Conclusion ..................................................................................154
References...........................................................................................155
4 Intensive Hemodialysis in the Clinic and at Home.........................167
Philip A. McFarlane
4.1 Introduction................................................................................ 168
4.2 The Home Nocturnal Hemodialysis Technique ......................... 176
XVI
Contents
4.3 Rationale for Intensive Hemodialysis ........................................ 178
4.4 Determining Adequacy of Dialysis in People Undergoing
Intensive Hemodialysis .............................................................. 187
4.5 Economic Considerations........................................................... 201
4.6 Selecting Patients for Intensive Hemodialysis ........................... 204
4.7 Candidacy and Home Hemodialysis Requirements ................... 205
4.8 Performing Intensive Hemodialysis Safely................................ 214
4.9 Conclusions ................................................................................ 218
References...........................................................................................219
5 Vascular Access for Hemodialysis Therapy....................................235
A.S. Bode, J.H.M. Tordoir
5.1 End-Stage Renal Disease ............................................................236
5.2 History of Vascular Access.........................................................238
5.3 Options for Vascular Access.......................................................242
5.4 Pre-operative Work-Up ...............................................................260
5.5 Using Arteriovenous Fistula .......................................................266
5.6 Vascular Access Complications and Their Treatment ................269
5.7 Hemodynamic Aspects of Arteriovenous Fistulas ......................280
5.8 Conclusion and Future Directions for Vascular Access..............286
References...........................................................................................287
6 Access Flow Monitoring Methods....................................................305
Daniel Schneditz, Laura M. Rosales, Ahmad Taher Azar
6.1 Introduction.................................................................................306
6.2 Peripheral Access ........................................................................307
6.3 Flow Measurement......................................................................310
6.4 Extracorporeal Application .........................................................314
6.5 Access Flow ................................................................................318
6.6 Bolus Approach...........................................................................321
6.7 Continuous Infusion Approach ...................................................323
6.8 Line Switches ..............................................................................329
6.9 Arterio-Venous Gradients ...........................................................330
6.10 Conclusion.................................................................................334
References...........................................................................................335
7 Hemodialysis Water Treatment System..........................................347
Ahmad Taher Azar, Suhail Ahmad
7.1 Water Contaminants....................................................................348
7.2 Methods of Hemodialysis Water Purification.............................350
7.3 Disinfection of Water Treatment Systems ..................................368
Contents
XVII
7.4 Monitoring and Testing of Dialysis Water Treatment System....369
7.5 Conclusion ..................................................................................372
References...........................................................................................372
8 Dialyzer Performance Parameters ..................................................379
Ahmad Taher Azar
8.1 Performance Characteristics of Dialyzers ...................................380
8.2 Factors Affecting Solute Clearance on Hemodialysis.................401
8.3 High Efficiency Dialysis .............................................................413
8.4 Conclusion ..................................................................................417
References...........................................................................................418
9 Dialyzer Structure and Membrane Biocompatibility ....................427
Orfeas Liangos, Bertrand L. Jaber
9.1 Introduction.................................................................................428
9.2 Overview of Dialyzer Structure ..................................................429
9.3 Materials Used for Artificial Kidney Membranes.......................430
9.4 Key Features of Biocompatibility ...............................................434
9.5 Clinical Implications of Dialysis Membrane
Biocompatibility..........................................................................450
9.6 Conclusion ..................................................................................455
References...........................................................................................456
10 Dialyzer Reprocessing.....................................................................481
Wayne Carlson
10.1 History of Dialyzer Reprocessing ...........................................482
10.2 Guidance and Regulation of Dialyzer Reprocessing...............486
10.3 The Process of Dialyzer Reprocessing....................................486
10.4 Manual and Automated Reprocessing.....................................495
10.5 Advantages and Disadvantages of Dialyzer Reprocessing ....498
10.6 Water Quality..........................................................................505
10.7 Anti-N Antibodies...................................................................507
10.8 Reuse Associated Changes in Ultrafiltration Coefficient........508
10.9 Current Controversies .............................................................509
10.10 Conclusion and Future Developments ..................................510
References.........................................................................................510
11 Flow Modeling of Hollow Fiber Dialyzers ....................................519
Manuel Prado-Velasco
11.1 General Issues of Dialyzer Flows............................................520
11.2 Flow Modeling in a Whole Scenario.......................................529
11.3 1D Diffusive Model of a Hollow Fiber Dialyzer ....................537
XVIII
Contents
11.4 Succinct Review of Lacks of 1D Diffusive Flow Modeling
of Hollow Fiber Dialyers……………...……………………..545
11.5 A Deeper Insight in the Flow Modeling of Dialyzers .............546
11.6 Flow Modeling of Dialyzers: Progress and Future .................552
11.7 Conclusion...............................................................................553
References.........................................................................................554
12 Single Pool Urea Kinetic Modeling................................................563
Alicja E. Grzegorzewska, Ahmad Taher Azar, Laura M. Roa,
J. Sergio Oliva, José A. Milán, Alfonso Palma
12.1 Compartment Effects in Hemodialysis ...................................564
12.2 Historical Review of Urea Kinetic Modeling ..........................565
12.3 Single Pool Urea Kinetic Model (SPUKM)............................571
12.4 Mathematical Models for Hemodialysis Dose Calculation.....584
12.5 Optimum Single Pool Hemodialysis Dose..............................592
12.6 Residual Renal Function and Dialysis Dose ...........................595
12.7 Normalized Protein Catabolic Rate (Protein Nitrogen
Appearance) and Dialysis Dose ...............................................600
12.8 Dynamic Approach to Kt/V: The Time Constant
in Hemodialysis.......................................................................608
12.9 Final Remarks and Conclusions..............................................610
References.........................................................................................613
13 Double Pool Urea Kinetic Modeling..............................................627
Ahmad Taher Azar, Masatomo Yashiro, Daniel Schneditz,
Laura M. Roa
13.1 Single Pool Model versus Double Pool Model .......................628
13.2 Double Pool Urea Kinetic Model............................................630
13.3 Estimation of Equilibrated Post-dialysis Blood Urea
Concentration ..........................................................................640
13.4 Estimation of Post-dialysis Urea Rebound..............................643
13.5 Estimation of Equilibrated Dialysis Dose eq(Kt/V) .................645
13.6 Regional Blood Flow Model...................................................655
13.7 Conclusion...............................................................................668
References.........................................................................................676
14 Applications of Bioimpedance to End Stage Renal
Disease (ESRD)................................................................................689
Laura M. Roa, David Naranjo, Javier Reina-Tosina, Alfonso Lara,
José A. Milán, Miguel A. Estudillo, J. Sergio Oliva
14.1 Introduction.............................................................................690
14.2 History of Bioimpedance ........................................................695
Contents
XIX
14.3 Physical Principles of Bioimpedance......................................698
14.4 Bioimpedance Instrumentation Basics ....................................709
14.5 Bioimpedance Measurement Techniques................................714
14.6 Nephrology Applications ........................................................730
14.7 Commercial Devices ...............................................................738
14.8 Case Studies ............................................................................742
14.9 Conclusion...............................................................................751
References.........................................................................................753
Author Index ..........................................................................................771
Contributing Authors
Ahmad Taher Azar
Assistant Professor, Computer and Software Engineering Department,
Faculty of Engineering, Misr University for Science & Technology
(MUST), 6th of October City, Egypt.
Editor in Chief of International Journal of System Dynamics
Applications (IJSDA), IGI-Global, USA.
e-mail: ahmad_t_azar@ieee.org
Alexandre Granger Vallée
Lapeyronie University Hospital - CHRU Montpellier, France
e-mail: alexandre.granger@videotron.ca
Alicja E. Grzegorzewska
PoznaĔ University of Medical Sciences, Poland
e-mail: alicja_grzegorzewska@yahoo.com
Alfonso Lara
Biomedical Engineering Group, University of Sevilla, ESI, Seville, Spain/
Service of Nephrology, University Hospital Virgen Macarena, Seville,
Spain
e-mail: alararnet@hotmail.com
Alfonso Palma: MD, PhD
Senior Researcher at the Biomedical
Engineering Group of the University of Seville, Spain.
e-mail: apalmaa@senefro.org
Andrea Cavalli
“A. Manzoni” Hospital Departement of Nephrology,
Dialysis and Renal Transplant, Italy
e-mail: a.cavalli@ospedale.lecco.it
XXII
Contributing Authors
Antonio Santoro
Nephrology Dialysis Hypertension Unit;
Policlinico S.Orsola-Malpighi, Italy
e-mail: antonio.santoro@aosp.bo.it
Aron S. Bode
Maastricht University Medical Center, The Netherlands
e-mail: dr.as.bode@gmail.com
Ashita Jiwat Tolwani
University of Alabama at Birmingham, USA
e-mail: atolwani@uab.edu
Bernard Canaud MD, PhD
Professor of Nephrology Montpellier II University School of Medicine;
Head, Nephrology, Dialysis and Intensive Care Unit, Lapeyronie Hospital,
Montpellier, France
e-mail: b-canaud@chu-montpellier.fr
Bertrand L. Jaber
Associate Professor of Medicine St. Elizabeth's Medical Center,
Department of Medicine, USA
e-mail: bertrand.jaber@steward.org
Casper F.M. Franssen
University Medical Center Groningen Department of Internal Medicine,
Division of Nephrology, The Netherlands
e-mail: c.f.m.franssen@int.umcg.nl
Celestina Manzoni
“A. Manzoni” Hospital Departement of Nephrology, Dialysis and
Renal Transplant, Italy
e-mail: c.manzoni@ospedale.lecco.it
Claudio Ronco
San Bortolo Hospital, Italy
e-mail: cronco@goldnet.it
Daniel Schneditz
Medical University of Graz, Institute of Physiology, Austria
e-mail: daniel.schneditz@medunigraz.at
Contributing Authors
XXIII
Elena Mancini
Nephrology Dialysis Hypertension Unit; Policlinico S. Orsola-Malpighi,
Italy
e-mail: elena.mancini@aosp.bo.it
Elmer Fernandez
CONICET - School of Engineering, Universidad Católica de Córdoba,
Argentina
e-mail: elmerfer@gmail.com
David Naranjo
Network Center of Biomedical Research in Bioengineering,
Biomaterials and Nanomedicine (CIBER-BBN)/
Biomedical Engineering Group,
University of Sevilla, ESI, Seville, Spain
e-mail: davidazuaga@gmail.com
Declan G. de Freitas
Consultant Nephrologist, Assistant Adjunct Professor, UK
e-mail: declan.defreitas@cmft.nhs.uk
Fredrik Uhlin
Department of Nephrology UHL, County Council of Östergötland and
Department of Medical Health Sciences, Faculty of Health Sciences,
Linköping University, Linköping, Sweden
e-mail: fredrik.uhlin@lio.se
Francesco Locatelli
“A. Manzoni” Hospital Departement of Nephrology,
Dialysis and Renal Transplant, Italy
e-mail: f.locatelli@ospedale.lecco.it
Geoff McDonnell
Centre for Health Informatics, University of News South Wales,
Coogee Campus, Sydney
e-mail: gmcdonne@bigpond.net.au
Giuseppe Pontoriero
“A. Manzoni” Hospital Departement of Nephrology,
Dialysis and Renal Transplant, Italy
e-mail: g.pontoriero@ospedale.lecco.it
Hélène Leray Moraguès
Lapeyronie University Hospital - CHRU Montpellier, France
e-mail: h-leray_moragues@chu-montpellier.fr
XXIV
Contributing Authors
Ivo Fridolin
Department of Biomedical Engineering, Technomedicum,
Tallinn University of Technology, Estonia
e-mail: ivo@cb.ttu.ee
Jan H.M. Tordoir
Maastricht University Medical Center, The Netherlands
e-mail: j.tordoir@mumc.nl
Javier Reina-Tosina
Network Center of Biomedical Research in Bioengineering,
Biomaterials and Nanomedicine (CIBER-BBN), Spain
e-mail: jreina@us.es
J. Chris White
ViaSim Solutions, USA
e-mail: jcwhite@viasimsolutions.com
J. Sergio Oliva
Biomedical Engineering Group, University of Sevilla, ESI, Seville, Spain
e-mail: joliva@us.es
John H. Crabtree
Department of Surgery, Southern California Permanente Medical Group,
Kaiser Permanente Downey Medical Center, Downey, California;
Visiting Clinical Faculty, Division of Nephrology and Hypertension,
Harbor- University of California Los Angeles Medical Center, Torrance,
California, USA
e-mail: johncrabtree@sbcglobal.net
Jorge Cerda
Albany Medical College, USA
e-mail: cerdaj@mail.amc.edu
José A. Milán
Biomedical Engineering Group, University of Sevilla, ESI, Seville, Spain /
Network Center of Biomedical Research in Bioengineering,
Biomaterials and Nanomedicine (CIBER-BBN)/ Service of Nephrology,
University Hospital Virgen Macarena, Seville, Spain
e-mail: josea.milan.sspa@juntadeandalucia.es
Judith J. Dasselaar
University Medical Center Groningen Department of Internal Medicine,
Division of Nephrology, The Netherlands
e-mail: judithdasselaar@home.nl
Contributing Authors
XXV
Karen Chia-Ying To
McMaster University, Canada
e-mail: karen.to@medportal.ca
Kenneth Scott Brimble
McMaster University, Canada
e-mail: brimbles@mcmaster.ca
Luciano Alberto Pedrini
Department of Nephrology and Dialysis. Bolognini Hospital – Seriate,
Italy
e-mail: luciano.pedrini@fmc.ag.com
Laura M. Roa
Biomedical Engineering Group, University of Sevilla, ESI, Seville, Spain /
Network Center of Biomedical Research in Bioengineering,
Biomaterials and Nanomedicine (CIBER-BBN), Spain
e-mail: lroa@us.es
Laura M. Rosales
Renal Research Institute, USA
e-mail: lrosales@rriny.com
Laure Patrier
Lapeyronie University Hospital - CHRU Montpellier, France
e-mail: l.patrier@chu-montpellier.fr
Leila Chenine Koualef
Lapeyronie University Hospital - CHRU Montpellier, France
e-mail: l-chenine@chu-montpellier.fr
Leonard M. Ebah
Specialist Registrar in Renal Medicine, UK
e-mail: leonard.ebah@cmft.nhs.uk
Manuel Prado Velasco
M2TB, University of Seville, Spain
e-mail: mpradovelasco@ieee.org
Marion Morena
Lapeyronie University Hospital - CHRU Montpellier & Institut de
Recherche et Formation en Dialyse, France
e-mail: marion.morena@gmail.com
XXVI
Contributing Authors
Masatomo Yashiro
Division of Nephrology, Kyoto City Hospital, Japan
e-mail: yashiro@pearl.ocn.ne.jp
Michael Francis Flessner
National Institutes of Health USA
e-mail: flessnermf@niddk.nih.gov
Maurizio Nordio
Nephrology and Dialysis Unit - ULSS 15 “Alta Padovana”, Italy
e-mail: maurizio.nordio@gmail.com
Miguel Ángel Estudillo
Network Center of Biomedical Research in Bioengineering,
Biomaterials and Nanomedicine (CIBER-BBN)/ Biomedical Engineering
Group, University of Sevilla, ESI, Seville, Spain
e-mail: m.estudillo@gmail.com
Monica Graciela Balzarini
CONICET - Biometrics Department, School of Agronomy,
Universidad Nacional de Cordoba, Argentina
e-mail: mbalzari@gmail.com
Nathan W. Levin
Renal Research Institite, USA
e-mail: nlevin@rriny.com
Nestor Velasco
Crosshouse Hospital, Kilmarnock, United Kingdom
e-mail: Nestor.Velasco@aaaht.scot.nhs.uk
Orfeas Liangos
Adjunct Assistant Professor of Medicine Tufts University
School of Medicine Klinikum Coburg Coburg, Germany
e-mail: liangos_o@hotmail.com
Philip Alan McFarlane
St. Michael's Hopsital, University of Toronto, Canada
e-mail: phil.mcfarlane@utoronto.ca
Pranay Kathuria
University of Oklahoma School of Medicine, USA
e-mail: pranay-kathuria@ouhsc.edu
Contributing Authors
XXVII
Rajnish Mehrotra
Associate Chief, Division of Nephrology and Hypertension,
Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA,
and Professor of Medicine, David Geffen School of Medicine at UCLA,
Los Angeles, CA, USA
e-mail: rmehrotra@labiomed.org
Rodolfo Valtuille
Fresenius Medical Care Argentina, Argentina
e-mail: rvaltuille@gmail.com
Salvatore Di Filippo
“A. Manzoni” Hospital Departement of Nephrology, Dialysis and
Renal Transplant, Italy
e-mail: s.difilippo@ospedale.lecco.it
Shamik Shah
Apollo Hospitals Ahmedabad, India
e-mail: shamik.shah@yahoo.com
Silvio Giove
Department of Economics, University of Venice, Italy
e-mail: sgiove@unive.it
Suhail Ahmad MD
Associate Professor of Medicine University of Washington;
Medical Director, Scribner Kidney Center, Seattle, Washington
e-mail: sahmad@u.washington.edu
Thomas M. Kitzler
McGill University-Divison of Nephrology Lyman Duff Medical Building
Montreal, Quebec, Canada
e-mail: thomas.kitzler@mcgill.ca
Wayne G. Carlson
Minntech Corp. USA
e-mail: wcarlson@minntech.com