Complementary parameter for dialysis monitoring based on UV absorbance.
An optical on-line monitoring system aimed at the estimation of dialysis dose has been tested clinically. The natural logarithmic slope is used to calculate Kt/V(urea) from ultraviolet (UV)-absorbance measurements. Errors in the calculation of Kt/V(urea) may appear due to changes in blood and dialysate flow or due to disturbances when the slope is used to estimate dialysis dose. This study introduces a new parameter for dialysis monitoring that may be used as a complementary parameter, the area under UV-absorbance curve (AUCa), to reflect a total solute removal during dialysis. The aim was to investigate the relationship between this new dialysis on-line monitoring parameter, AUCa, and the total removal of a few solutes. Fifteen patients were monitored during hemodialysis using UV absorbance at the wavelength of 297 nm. All spent dialysate passed through a flow cuvette in a spectrophotometer and then further to a collection tank where solute concentrations in the entire spent dialysate were determined. The AUCa at 297 nm was compared with the total amount of removed solute in the tank (reference method). The result shows strong correlations between AUCa and the total removal of urea, urate, creatinine, and phosphate during a given treatment and less strong correlation in all 15 patients together. A first indication of a new, possible, complementary parameter in hemodialysis treatment is presented, the AUCa, prospected to estimate solute removal.
Uhlin
Fredrik
F
Department of Nephrology, University Hospital, Linköping, Sweden. fredrik.uhlin@lio.se
Pettersson
Jonas
J
Fernström
Anders
A
Lindberg
Lars-Göran
LG
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D013056:Spectrophotometry, Ultraviolet; D013997:Time Factors; D014466:Ultraviolet Rays