# Rapid prototyping of multi-compartment models for urea kinetics in hemodialysis: a System Dynamics approach

## TL;DR

This paper shows how System Dynamics can be used to create accessible and effective multi-compartment models for understanding urea kinetics in hemodialysis.

## Contribution

The paper introduces a System Dynamics approach for modeling urea kinetics that is intuitive, efficient, and accessible to practitioners.

## Key findings

- The System Dynamics model performs as well as a more complex volume-average model in fitting clinical data.
- The model is intuitive and easy to modify, making hemodialysis modeling more accessible.
- System Dynamics can be a valuable tool for urea kinetics modeling in clinical settings.

## Abstract

Models of urea kinetics facilitate a mechanistic understanding of urea transfer and provide a tool for optimizing dialysis efficacy. Dual-compartment models have largely replaced single-compartment models as they are able to accommodate the urea rebound on the cessation of dialysis. Modeling the kinetics of urea and other molecular species is frequently regarded as a rarefied academic exercise with little relevance at the bedside. We demonstrate the utility of System Dynamics in creating multi-compartment models of urea kinetics by developing a dual-compartment model that is efficient, intuitive, and widely accessible to a range of practitioners. Notwithstanding its simplicity, we show that the System Dynamics model compares favorably with the performance of a more complex volume-average model in terms of calibration to clinical data and parameter estimation. Its intuitive nature, ease of development/modification, and excellent performance with real-world data may make System Dynamics an invaluable tool in widening the accessibility of hemodialysis modeling.

The online version contains supplementary material available at 10.1007/s10047-023-01416-w.