Optical Monitoring of Dialysis Dose

Uhlin, Fredrik; Fridolin, Ivo

doi:10.1007/978-3-642-27558-6_3

Cited by 7 publications

(5 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The slope of online UV absorbance signal from the spent dialysate against time enables one to estimate the value of Kt/V ( Figure 3 I). Method for acquiring the online UV absorbance signal is described in detail elsewhere [ 18 ]. Self-tests of the dialysis machine occur as spikes in the signal.…”

Section: Resultsmentioning

confidence: 99%

Do Only Small Uremic Toxins, Chromophores, Contribute to the Online Dialysis Dose Monitoring by UV Absorbance?

Arund

Tanner

Uhlin

et al. 2012

Toxins

Self Cite

View full text Add to dashboard Cite

The aim of this work was to evaluate the contributions of the main chromophores to the total UV absorbance of the spent dialysate and to assess removal dynamics of these solutes during optical on-line dialysis dose monitoring. High performance chromatography was used to separate and quantify UV-absorbing solutes in the spent dialysate sampled at the start and at the end of dialysis sessions. Chromatograms were monitored at 210, 254 and 280 nm routinely and full absorption spectra were registered between 200 and 400 nm. Nearly 95% of UV absorbance originates from solutes with high removal ratio, such as uric acid. The contributions of different solute groups vary at different wavelengths and there are dynamical changes in contributions during the single dialysis session. However, large standard deviation of the average contribution values within a series of sessions indicates remarkable differences between individual treatments. A noteworthy contribution of Paracetamol and its metabolites to the total UV absorbance was determined at all three wavelengths. Contribution of slowly dialyzed uremic solutes, such as indoxyl sulfate, was negligible.

show abstract

Section: Resultsmentioning

confidence: 99%

Do Only Small Uremic Toxins, Chromophores, Contribute to the Online Dialysis Dose Monitoring by UV Absorbance?

Arund

Tanner

Uhlin

et al. 2012

Toxins

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, Vasquez-Rios et al recently determined that the monitoring of urea removal during haemodialysis treatment by UV absorbance was not unique for a single substance and may be influenced by the intake of medications, such as Par [13]. The administration of Par may similarly affect urea-removal monitoring near 280 nm, the UV region commonly used in commercial UV monitors [1][2][3][4]13] to evaluate urea removal. Our results that describe the Par effect on UA-removal monitoring raise the importance of this issue and it requires a more detailed analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Optical ultraviolet (UV)-absorbance monitoring of spent dialysate on the outflow from a dialysis machine has become feasibly applied worldwide for assessing the removal of low-molecular-weight uremic solutes from patients' blood by a haemodialysis procedure [1][2][3][4]. In addition, a strong correlation has been found between optical properties of spent dialysate and concentration of characteristic uremic toxins, such as uric acid (UA) [5,6], indoxyl sulfate (IS) [7], and β-2-microglobulin [8,9].…”

Section: Introductionmentioning

confidence: 99%

Treatment with Paracetamol Can Interfere with the Intradialytic Optical Estimation in Spent Dialysate of Uric Acid but Not of Indoxyl Sulfate

Adoberg

Paats

Arund

et al. 2022

Toxins

Self Cite

View full text Add to dashboard Cite

Optical online methods are used to monitor the haemodialysis treatment efficiency of end stage kidney disease (ESKD) patients. The aim of this study was to analyse the effect of the administration of UV-absorbing drugs, such as paracetamol (Par), on the accuracy of optical monitoring the removal of uremic toxins uric acid (UA) and indoxyl sulfate (IS) during standard haemodialysis (HD) and haemodiafiltration (HDF) treatments. Nine patients received Par in daily dosages 1–4 g for 30 sessions. For 137 sessions, in 36 patients the total daily dosage of UV-absorbing drugs was less than 500 mg, and for 6 sessions 3 patients received additional UV-absorbing drugs. Par administration slightly affected the accuracy of optically assessed removal of UA expressed as bias between optically and laboratory-assessed reduction ratios (RR) during HD but not HDF employing UV absorbance of spent dialysate (p < 0.05) at 295 nm wavelength with the strongest correlation between the concentration of UA and absorbance. Corresponding removal of IS based on fluorescence at Ex280/Em400 nm during HD and HDF was not affected. Administration of UV-absorbing drugs may in some settings influence the accuracy of optical assessments in spent dialysate of the removal of uremic solutes during haemodialysis treatment of ESKD patients.

show abstract

“…Earlier research has demonstrated potential of intradialytic optical monitoring to estimate the removal of low molecular weight uremic solutes other than uric acid as urea [53] and creatinine [82] with their clinical implications. Furthermore, optical monitoring of low molecule weight uremic solutes removal by HD, assessed via the marker molecule urea-related dialysis adequacy parameters, has become a worldwide practice [55, 56,83]. A possibility for optical monitoring of phosphate and calcium elimination during dialysis has also been presented [84,85].…”

Section: (B) An Example Of the Regression Line Between Concentration ...mentioning

confidence: 99%

Optical Online Monitoring of Uremic Toxins beyond Urea

Uhlin,

Fridolin

2023

Updates on Hemodialysis

Self Cite

View full text Add to dashboard Cite

This chapter presents origin and physical basis of the optical method for traditional haemodialysis (HD) dose assessment, accepted as a valid bloodless, robust, automatic, in situ and online monitoring technology in clinical praxis. Dialysis dose Kt/V, total removed urea (TRU) and the nutrition parameters PCR, nPCR estimation from ultraviolet (UV) absorbance in the spent dialysate is explained. Since urea, a small water-soluble uremic solute and a surrogate marker for the efficiency of dialysis treatment to clear the blood of toxins and metabolic end products, is not representative for all retained uremic toxins removed with the modern dialysis care, new developments of optical online monitoring of uremic toxins, beyond urea, are discussed. Optical intradialytic monitoring of small-, middle- and protein-bound molecules’ removal, exemplified by marker molecules uric acid, beta-2 microglobulin and indoxyl sulphate, is described. A new concept and sensor technology for multi-component uremic toxins’ intradialytic optical monitoring of spent dialysate with some clinical examples are introduced. Drug interference studies during the optical dialysis monitoring and future directions in optical monitoring are included. Offered benefits will be more patient-centred, integrated and cost-efficient care, as feedback for clinicians helps to improve and personalize the treatment quality, minimizing costly adverse effects.

show abstract

Optical Monitoring of Dialysis Dose

Cited by 7 publications

References 68 publications

Do Only Small Uremic Toxins, Chromophores, Contribute to the Online Dialysis Dose Monitoring by UV Absorbance?

Do Only Small Uremic Toxins, Chromophores, Contribute to the Online Dialysis Dose Monitoring by UV Absorbance?

Treatment with Paracetamol Can Interfere with the Intradialytic Optical Estimation in Spent Dialysate of Uric Acid but Not of Indoxyl Sulfate

Optical Online Monitoring of Uremic Toxins beyond Urea

Contact Info

Product

Resources

About