Determination of Glucose Levels during Dialysis Treatment: Different Sensors and Technologies

Sbrignadello, Stefano; Pacini, Giovanni; Tura, Andrea

doi:10.1155/2016/8943095

Cited by 5 publications

(3 citation statements)

References 45 publications

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“…A non-invasive plasma glucose determination based on optical approaches has been proposed, but, probably due to several confounding factors, no satisfactory solution has yet been found [ 41 ]. However, during HD, glucose determination with an optical sensor working directly on the tubing of the extracorporeal circulation may be simpler and more effective than a similar determination in a non-dialysis patient during normal times.…”

Section: How To Control the Glycemic Status In Patients In Maintenanc...mentioning

confidence: 99%

The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview

Cavallari¹,

Mancini²

2022

JCM

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Diabetes mellitus is the leading cause of renal failure in incident dialysis patients in several countries around the world. The quality of life for patients with diabetes in maintenance hemodialysis (HD) treatment is in general poor due to disease complications. Nephrologists have to cope with all these problems because of the “total care model” and strive to improve their patients’ outcome. In this review, an updated overview of the aspects the nephrologist must face in the management of these patients is reported. The conventional marker of glycemic control, hemoglobin A1c (HbA1c), is unreliable. HD itself may be responsible for dangerous hypoglycemic events. New methods of glucose control could be used even during dialysis, such as a continuous glucose monitoring (CGM) device. The pharmacological control of diabetes is another complex topic. Because of the risk of hypoglycemia, insulin and other medications used to treat diabetes may need dose adjustment. The new class of antidiabetic drugs dipeptidyl peptidase 4 (DPP-4) inhibitors can safely be used in non-insulin-dependent end-stage renal disease (ESRD) patients. Nephrologists should take care to improve the hemodynamic tolerance to HD treatment, frequently compromised by the high level of ultrafiltration needed to counter high interdialytic weight gain. Kidney and pancreas transplantation, in selected patients with diabetes, is the best therapy and is the only approach able to free patients from both dialysis and insulin therapy.

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Section: How To Control the Glycemic Status In Patients In Maintenanc...mentioning

confidence: 99%

The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview

Cavallari¹,

Mancini²

2022

JCM

View full text Add to dashboard Cite

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“…Non-invasive sensors are particularly useful to avoid the expense of disposable material and probes [16], [18], [20], [21]. Optical sensors are mainly used for the purpose of relative blood volume (RBV) estimation [22], [23], but other uses have also been proposed [16], [17], [19], [24], [25]. Relative blood volume is defined as the relative variation in volume of the body's blood compartment in comparison with that at the beginning of the session.…”

Section: B Optical Sensors In Hemodialysis and Hemofiltrationmentioning

confidence: 99%

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

Visotti¹,

Ravagli

Perazzini³

et al. 2018

IEEE Sensors J.

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Abstract-Hemofiltration (HF) is a group of blood purification therapies used to treat patients with kidney injury. HF works using a process called ultrafiltration (UF) that removes excess liquid accumulated in the patient's body caused by lack of excretion. UF progress is monitored by the HF machine, but the state-of-the-art method is cumbersome and could be more accurate. In this work, a system composed by two optical sensors is proposed for real-time non-invasive estimation of ultrafiltration rate. This new system is simple, rugged, low-cost and operates on sound theoretical foundations. The sensor system has been tested with two different experimental protocols and showed good correlation between its output and the reference value of the ultrafiltration rate (R 2 =0.97), as well as improved accuracy compared to the available commercial machine (≃12ml/h). This system also has the potential to simplify the architecture required by critical care blood purification machines to perform UF control.Index Terms -Biomedical Measurement, Blood, Blood Purification, Hemofiltration, Hemoglobin, Measurement, Optical Sensor, Ultrafiltration I. INTRODUCTIONRenal replacement therapies (RRTs) have been developed to treat individuals affected by kidney failure, known as nephropathic patients. RRTs have the following targets:• Removal of excess fluid accumulated by the patient due to lack of kidney excretion.• Re-balancing concentration of specific substances in blood, for example electrolytes such as sodium.• Removal of the toxic by-products of metabolism, such as urea.Several types of therapies and machines have been developed. The main distinction of therapies is between those developed † First two authors A. Visotti and E. Ravagli contributed equally to this work. A. Visotti, C. Perazzini, D. Drudi, and C. Ghidini are with the company IBD Srl (https://www.ibdsrl.com/), Forlì, Italy.E. Ravagli and S. Severi* are with the Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy (e-mail: stefano.severi@unibo.it).to treat patients with acute kidney injury (AKI), who are expected to partially or fully regain kidney functionality, and those for patients with chronic kidney disease (CKD), who require periodic treatment for the rest of their lives or until kidney transplant. Therapies such as hemodialysis [1]-[3] and peritoneal dialysis [4] are the standard for CKD patients; while for AKI, slow, prolonged, one-time treatments are chosen to perform blood purification until kidney function is regained [5]- [7]. The effect of RRTs on the patient has been studied both clinically and with mathematical tools such as kinetic models, developed to describe the transfer of water and solutes across body compartments during .This work represents a technological improvement for AKI therapies where fluid removal is the main target -therapies also known as hemofiltration (HF). Fluid removal is performed by means of a physical principle called ultrafiltration (UF) [11]-[13]. Example...

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“…During the procedure, the glycemia tends to decrease, while it increases when the HD session ends. Thus, at least for HD diabetic patients, a non-invasive, pain-free, on-line glycemia monitoring would be beneficial as both hypo-and hyperglycemia should be avoided [4].…”

Section: Introductionmentioning

confidence: 99%

Glucose concentration monitoring using near-infrared spectrum of spent dialysis fluid in hemodialysis patients

et al. 2020

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Introduction/Objective. Diabetic nephropathy leading to end-stage renal disease is a major health problem worldwide. Hemodialysis treatment is associated with glycemia variations. Diabetic patients on hemodialysis might benefit from a noninvasive online glycemia monitoring system. The aim of this study was to assess the glucose concentration from the matrix of the spent dialysate fluid using Near infrared (NIR) Spectroscopy. Methods. Blood samples and spent dialysate have been collected in the 15th minute of the hemodialysis treatment from 15 patients. The spent dialysis fluid has been characterized by a NIR spectrometer in the range of 900-1300 nm. In order to apply the artificial neural network (ANN) and train it, the MATLNFTOOL program was used. The testing and training of the ANN were executed using the NIR spectrum of the spent dialysis fluid as input, and the glucose concentration as output. Results. A significant correlation in excess of 93% between the NIR spectrum of the spent dialysate and the blood glucose concentration (3-9 mmol/l) has been found. Conclusions. NIR spectroscopy is a noninvasive and reliable method of glycemia monitoring which can be used in maintenance hemodialysis patients.

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Determination of Glucose Levels during Dialysis Treatment: Different Sensors and Technologies

Cited by 5 publications

References 45 publications

The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview

The Nephrologist’s Role in the Collaborative Multi-Specialist Network Taking Care of Patients with Diabetes on Maintenance Hemodialysis: An Overview

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

Glucose concentration monitoring using near-infrared spectrum of spent dialysis fluid in hemodialysis patients

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