On line UV-adsorbance measurements. Summary of the EDTNA/ERCA journal club discussion. Summer 2006.
The discussion was initiated by a paper comparing the measurement of dialysis dose (Kt/V) and solute clearance using on-line ultra-violet absorbance, blood and dialysate urea and ionic dialysance by Uhlin et al (NDT 2006). Participants from 14 countries discussed the theory behind the UV absorbance technique and the potential for its use in routine practice, the correlation between Kt/V measured using different methods, the use of ionic dialysance and the optimisation of dose monitoring. The 'take-home' messages from the discussion were that UV-absorbance could help ensure the delivery of dialysis dose as it provides real time feedback on the effect interventions such as repositioning of needles. The technology is relatively inexpensive and requires no consumables but changes in the dialysis machine settings could lead to misleading measurements if not communicated to the UV monitor. Session-to-session variation in dialysis dose can be measured using on-line clearance monitoring. If it is already on the machine and costs nothing, why not use it? Alternatively, regular access recirculation checks and a record of the total blood volume processed at each session allow problems with delivered dialysis dose to be picked up between routine blood tests.
Lindley
Elizabeth J
EJ
Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, UK.
De Vos
Jean Yves
JY
Morgan
Ian
I
Murcutt
Gareth
G
Hoenich
Nic
N
Polaschegg
Hans
H
Johnson
Andy
A
Daugirdas
John
J
Wüpper
Andreas
A
Ward
Richard
R
Gorke
Alois
A
Fettouhi
Maria
M
Milo
Elisheva
E
Sramek
Jiri
J
Nilsson
Eva-Lena
EL
Belot
Bertrand
B
Luman
Merike
M
Walker
Diane
D
Gerrish
Martin
M
Harrington
Maurice
M
Francis
Veronica
V
Iwaasa
Kathryn
K
Girak
Martha
M
Eleftheroudi
Marianna
M
Simard
Joan Camarro
JC
Fridolin
Ivo
I
Uhlin
Fredrik
F
D015314:Dialysis Solutions / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods; D013056:Spectrophotometry, Ultraviolet
D015314:Dialysis Solutions