A Newly Developed On‐line Monitoring System for the Determination of Serum Electrolytes and Urea During Hemodialysis

Abstract

Continuous monitoring of serum solute concentrations throughout a dialysis session could be beneficial for the prevention of intradialytic morbidity such as hypotension and for the confirmation of dialysis adequacy. In this paper, we introduce a new on-line monitoring system for use during hemodialysis sessions, a system developed for the continuous observation of serum biochemical data. Using this system, we also show the possibility of clinical applications. Intradialytic hypotension could be prevented by the observation of filtrate sodium concentration and the control of dialysate sodium concentration. The termination of a dialysis session could be decided by the observation of the filtrate urea nitrogen, on the basis of the Kt/V urea ratio. Because monitoring for other solutes such as calcium and creatinine is theoretically available, clinical applications will continue to increase in the future.

Dialysis hypotension: a review of recent studies of causative factors

“…This fluid imbalance also reduces blood volume and causes intradialytic hypotension. As for the BV monitor, monitoring, 27 simulation 28 and control 29,30 of sodium profiling 31 are also reported as recent clinical advances to prevent intradialytic hypotension.…”

Biosensors and flow-through system for the determination of creatinine in hemodialysate

“…The measurement of creatinine levels in serum and the determination of the renal clearance of creatinine are widely used to evaluate renal function by means of laboratory medicine [1,2]. In addition to urea [3,4,5,6,7,8,9], creatinine [10] has been proposed as a marker of hemodialysis adequacy. Monitoring creatinine concentrations in spent dialysate stream during dialysis sessions might offer a means to quantify the delivered dosage of detoxification and thus may be used to quantify the efficiency of dialysis.…”