In Vivo Verification of an Automatic Noninvasive System for Real Time Kt Evaluation

Measurement of dialyzer clearance, dialysis time, and body size: Death risk relationships among patients

“…Ionic dialysance can then be measured multiple times during the course of a dialysis treatment and values averaged during and after treatment. Ionic dialysance closely approximates urea dialysance for both commercial systems [11][12][13][14][15][34][35][36]. Urea dialysance equals urea clearance in single pass systems like those used for clinical dialysis [16] Thus, a good estimate of small molecule Kt can be conveniently determined as a running average during and as a final value after treatment.…”

“…Those values are averaged during the treatment to give an average Kecn × t product (Kt) [11]. The ionic dialysance so measured closely approximates the urea dialysance (r = 0.98; urea = −2.0 + 1.01 × ionic) [15].…”

“…The frequency of clinical dose estimates therefore has generally been limited to once monthly as a practical necessity. Technologies have recently been developed, however, whereby a clearance [average small molecule clearance (Kecn)] similar to urea clearance can be measured directly during the course of each treatment [11][12][13][14], called an on-line clearance. Average Kecn can be multiplied by t to produce the total dose parameter, Kt, at the end of treatment or even as a running value during the course of treatment.…”

The online measurement of hemodialysis dose (Kt): Clinical outcome as a function of body surface area

“…Recent technical advances permit direct measurement of small molecule clearance, called an effective on-line conductivity (or ionic) clearance (Kecn), during the course of each treatment [20][21][22][23]. The average Kecn is multiplied by t at the end of treatment to give a measured Kt.…”

Technical Challenges to Successful Dialyzer Reuse

“…The feasibility of on-line systems based on urea sensors has been demonstrated [17,18], and the clinical implementation of at least one of these systems currently awaits Food and Drug Administration approval. Other systems, based on conductivity mea surements, are also under development [19].…”