title: Real-time Kt/V determination by ultraviolet absorbance in spent dialysate: technique validation.
abstract: Real-time determination of Kt/V can be provided by monitoring ultraviolet absorbance of solutes in spent dialysate. This not only overcomes dependency on error-prone pre- and post-dialysis blood sampling; it circumvents inaccuracies associated with estimating the urea distribution volume and its high measurement frequency tightly reflects the course of the dialysis. Our study compared the ultraviolet-based spKt/V and eKt/V with the commonly used blood-based counterparts. A first study of 16 patients compared ultraviolet Kt/Vs against blood Kt/Vs obtained by using the 'gold standard' of serial blood samples. A second study included 18 patients and compared the ultraviolet and blood values under routine conditions. Both studies showed mean blood-based spKt/V and eKt/V values statistically indistinguishable from their ultraviolet-based counterparts. Hence, on-line monitoring of ultraviolet absorption of spent dialysate is applicable in routine hemodialysis allowing continuous measure of removed solutes from spent dialysate without disturbing the patient or treatment session.
authors.affiliation: B Braun Avitum AG, Melsungen, Germany. alex.castellarnau@gmail.com
authors.forename: Alex
authors.initials: A
authors.lastname: Castellarnau
authors.forename: Michael
authors.initials: M
authors.lastname: Werner
authors.forename: Roman
authors.initials: R
authors.lastname: Günthner
authors.forename: Marten
authors.initials: M
authors.lastname: Jakob
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D057205:Automation, Laboratory; D015415:Biomarkers / Q000097:blood; D004867:Equipment Design; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D006435:Renal Dialysis / Q000295:instrumentation; D015203:Reproducibility of Results; D013056:Spectrophotometry, Ultraviolet / Q000295:instrumentation; D013997:Time Factors; D014508:Urea / Q000032:analysis* / Q000097:blood; D014511:Uremia / Q000097:blood / Q000628:therapy*
chemical_list: D015415:Biomarkers; D015312:Hemodialysis Solutions; D014508:Urea