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Magnusson, Martin
Publications (10 of 15) Show all publications
Haarhaus, M., Fernström, A., Magnusson, M. & Magnusson, P. (2009). Clinical significance of bone alkaline phosphatase isoforms, including the novel B1x isoform, in mild to moderate chronic kidney disease. NEPHROLOGY DIALYSIS TRANSPLANTATION, 24(11), 3382-3389
Open this publication in new window or tab >>Clinical significance of bone alkaline phosphatase isoforms, including the novel B1x isoform, in mild to moderate chronic kidney disease
2009 (English)In: NEPHROLOGY DIALYSIS TRANSPLANTATION, ISSN 0931-0509, Vol. 24, no 11, p. 3382-3389Article in journal (Refereed) Published
Abstract [en]

Background. Mineral bone disorder (MBD) is a common complication of chronic kidney disease (CKD) even during the early stages. Bone alkaline phosphatase (BALP) is a marker of bone fort-nation and plays a pivotal role in the mineralization process. Three BALP isoforms (B/I, B1 and B2) have been identified in healthy individuals and a fourth isoform (B1x) has been discovered in serum from dialysis patients. We investigated these BALP isoforms, type I procollagen intact amino-terminal propeptide (PINP), carboxy-terminal telopeptide of type I collagen (CTX) and tartrate-resistant acid phosphatase isoform 5b (TRACP5b), as well as bone mineral density (BMD) in predialysis CKD patients. Methods. PINP, CTX, TRACP5b and BALP isoforms were analysed in serum from 46 patients within CKD stages 3-5. BMD was determined by dual-energy x-ray absorptiometry. Results. PINP, TRACP5b and the BALP isoforms, B/I, B1 and B2, were independent predictors of total hip BMD in all patients. Furthermore, B/I predicted osteopaenia in the hip and in the distal 1/3 of the radius in CKD stage 3. The B1x isoform was detected in nine patients (20%), who had lower GFR, higher phosphate and calcium x phosphate product. Conclusion. We found an association of BALP isoforms and other markers of bone turnover with total hip BMD, which predominantly comprises trabecular bone. The association of the new BALP isoform B1x with risk factors for vascular calcification leads us to hypothesize a possible role for B1x in this process. The significance of the BALP isoforms in CKD remains to be further explored in experimental and clinical settings in conjunction with bone histomorphometry.

Keywords
alkaline phosphatase, bone mineral density, bone turnover, mineral bone disorder, predialysis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-52373 (URN)10.1093/ndt/gfp300 (DOI)
Available from: 2009-12-18 Created: 2009-12-18 Last updated: 2014-11-06
Uhlin, F., Fridolin, I., Magnusson, M. & Lindberg, L.-G. (2006). Dialysis dose (Kt/V) and clearance variation sensitivity using measurement of ultraviolet-absorbance (on-line), blood urea, dialysate urea and ionic dialysance. Nephrology Dialysis Transplantation, 21(8), 2225-2231
Open this publication in new window or tab >>Dialysis dose (Kt/V) and clearance variation sensitivity using measurement of ultraviolet-absorbance (on-line), blood urea, dialysate urea and ionic dialysance
2006 (English)In: Nephrology Dialysis Transplantation, ISSN 0931-0509, Vol. 21, no 8, p. 2225-2231Article in journal (Refereed) Published
Abstract [en]

Background. An on-line monitoring system for dialysis dose calculations could make it possible to provide an adequate dialysis dose that is consistently given to haemodialysis (HD) patients. The aim of this study was to compare dialysis dose (Kt/V) using four different methods and their sensitiveness to a reduction in clearance.

Methods. Six patients were monitored on-line with ultraviolet (UV)-absorbance at a wavelength of 297 nm in three consecutive dialysis sessions during 1 week. During the last treatment, the clearance was reduced by 25% by decreasing the blood flow. For the determination of UV-absorbance, a spectrophotometer was connected to the fluid outlet of the dialysis machine with all spent dialysate passing through a flow cuvette. The equilibrated Kt/V (eKt/V) estimated by UV-absorbance was compared with eKt/V from the ionic dialysance method using the on-line clearance monitor (OCM) and the appurtenant software dose-calculation tool DCTool (Fresenius Medical Care, Germany), eKt/V calculated from the dialysate-urea slope and with eKt/V from pre- and post-dialysis blood-urea samples as reference.

Results. The study demonstrates that the sensitiveness to clearance reduction is similar in the four methods compared for eKt/V. When the different methods were compared, the mean eKt/V of UV-absorbance was 1.21 ± 0.20, blood 1.30 ± 0.21, dialysate 1.32 ± 0.21 and OCM (using the DCTool) 1.31 ± 0.21. The standard deviation was of the same magnitude.

Conclusion. The UV-method gives a similar response to clearance reduction compared with the other methods when comparing dialysis dose. The high sampling rate by continuous monitoring of UV-absorbance allows evaluation of the clearance process during dialysis and gives immediate feedback to on-line adjustments.

Keywords
clearance; haemodialysis monitoring; ionic dialysance; Kt/V; ultra violet absorption; urea
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14193 (URN)10.1093/ndt/gfl147 (DOI)
Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2009-06-05
Uhlin, F., Fridolin, I., Magnusson, M. & Lindberg, L.-G. (2006). Ultra violet absorbance on-line measurement utilized to monitor clinical events during haemodialysis. Journal of Renal Care, 32(3), 141-146
Open this publication in new window or tab >>Ultra violet absorbance on-line measurement utilized to monitor clinical events during haemodialysis
2006 (English)In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 32, no 3, p. 141-146Article in journal (Refereed) Published
Abstract [en]

Background: On-line monitoring systems of the spent dialysate, used to estimate dialysis dose, have been developed with different instrumentation during the last two decades. The routine use of an on-line monitoring system has been suggested to provide to give an adequate dialysis dose to the haemodialysis (HD) patients. The aim of this study was to show that monitoring the spent dialysate using UV-absorbance may bring new information about the clearance process. Methods: 108 HD treatments distributed among 16 clinical stable patients were monitored on-line using ultra violet (UV) absorbance. For the measurement of UV-absorbance a spectrophotometer was connected to the fluid outlet of the dialysis machine with all spent dialysate passing through a flow cuvette. The UV-absorbance curves were examined in combination with the recorded observations of events that occurred during the studied treatments.Results: The study demonstrates that UV-absorbance visualizes different kind of events such as hypotension, conductivity alarms, restricted flow in artery needle blood pump stop that often occur during dialysis treatment.Conclusion: An on-line UV-monitoring system with a high sampling rate makes it possibility to identify variations in dialysis clearance of different origin and gives feedback after performing interventions during a dialysis session

Keywords
dialysis adequacy; dialysis clearance; haemodialysis monitoring; on-line adjustments; ultra violet absorption
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14194 (URN)17393808 (PubMedID)
Note

Tidigare titel: [On line monitoring using ultraviolet absorption for surveillance of clinical events during hemodialysis]

Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2017-12-13
Uhlin, F., Fridolin, I., Lindberg, L.-G. & Magnusson, M. (2005). Clearance variation monitored by on-line UV-absorbance during haemodialysis. In: Nordic Baltic Conference Biomedical Engineering and medical physics,2005.
Open this publication in new window or tab >>Clearance variation monitored by on-line UV-absorbance during haemodialysis
2005 (English)In: Nordic Baltic Conference Biomedical Engineering and medical physics,2005, 2005Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33158 (URN)19138 (Local ID)19138 (Archive number)19138 (OAI)
Available from: 2009-10-09 Created: 2009-10-09
Uhlin, F., Fridolin, I., Lindberg, L.-G. & Magnusson, M. (2005). Estimating total urea removal and protein catabolic rate by monitoring UV absorbance in spent dialysate. Nephrology Dialysis Transplantation, 20(11), 2458-2464
Open this publication in new window or tab >>Estimating total urea removal and protein catabolic rate by monitoring UV absorbance in spent dialysate
2005 (English)In: Nephrology Dialysis Transplantation, ISSN 0931-0509, Vol. 20, no 11, p. 2458-2464Article in journal (Refereed) Published
Abstract [en]

Background. Dialysate-based, on-line measurements of Kt/V and protein catabolic rate (PCR) in dialysis patients have been considered more accurate compared with measurements on the blood side during dialysis. The primary aim of this study was to compare total removed urea (TRU) and PCR, normalized to body weight (nPCRw), obtained by three dialysate-based methods: (i) on-line ultraviolet (UV) absorbance of the spent dialysate; (ii) total dialysate collection (TDC), as reference method; and (iii) Urea Monitor 1000 (UM) from Baxter Healthcare Corp.

Methods. We studied 10 uraemic patients on chronic, thrice-weekly haemodialysis. We made absorption measurements (UV radiation) on-line with a spectrophotometer connected to the fluid outlet of the dialysis machine, with all spent dialysate passing through an optical cuvette for single-wavelength measurements. UV absorbance measurements were compared with TDC and the UM.

Results. nPCRw obtained with UV absorbance was 0.82±0.17, that from TDC 0.81±0.18, and that measured by UM 0.87±0.18, which was significantly higher than the results of the other methods. The difference between nPCRw calculated by TDC and by UM was –0.05±0.06, showing a slightly lower SD than the difference between nPCRw by TDC and UV absorbance, –0.01±0.07.

Conclusion. The study demonstrates that TRU, and consequently PCR, can be estimated by on-line measurement of the UV absorption in the spent dialysate.

Keywords
dialysis adequacy; haemodialysis monitoring; protein catabolic rate; total removed urea; urea; UV absorption
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14192 (URN)10.1093/ndt/gfi026 (DOI)
Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2009-06-05
Uhlin, F., Fridolin, I., Magnusson, M. & Lindberg, L.-G. (2005). Online monitoring of the spent dialysate during haemodialysis using UV absorbance. In: European Dialysis Transplant nurse assosiation EDTNA,2005.
Open this publication in new window or tab >>Online monitoring of the spent dialysate during haemodialysis using UV absorbance
2005 (English)In: European Dialysis Transplant nurse assosiation EDTNA,2005, 2005Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33157 (URN)19137 (Local ID)19137 (Archive number)19137 (OAI)
Available from: 2009-10-09 Created: 2009-10-09
Haarhaus, M., Fernström, A., Larsson, L., Magnusson, P. & Magnusson, M. (2004). Evaluation of bio-intact (1-84) parathyroid hormone, vitamin D status and bond mineral density in patients with predialysis chronic renal failure. In: ASN Renal Week,2004.
Open this publication in new window or tab >>Evaluation of bio-intact (1-84) parathyroid hormone, vitamin D status and bond mineral density in patients with predialysis chronic renal failure
Show others...
2004 (English)In: ASN Renal Week,2004, 2004Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-23501 (URN)2965 (Local ID)2965 (Archive number)2965 (OAI)
Available from: 2009-10-07 Created: 2009-10-07
Uhlin, F., Fridolin, I., Lindberg, L.-G. & Magnusson, M. (2004). Icke-invasiv kontinuerlig övervakning av bloddialys UV absorption. In: Njurmedicins regionmöte,2004.
Open this publication in new window or tab >>Icke-invasiv kontinuerlig övervakning av bloddialys UV absorption
2004 (Swedish)In: Njurmedicins regionmöte,2004, 2004Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28730 (URN)13902 (Local ID)13902 (Archive number)13902 (OAI)
Available from: 2009-10-09 Created: 2009-10-09
Uhlin, F., Fridolin, I., Lindberg, L.-G. & Magnusson, M. (2004). Protein catabolic rate estimated by on-line monitoring of the UV-absorbance in the Spent Dialysate. In: American Society of Nephrology,2004.
Open this publication in new window or tab >>Protein catabolic rate estimated by on-line monitoring of the UV-absorbance in the Spent Dialysate
2004 (English)In: American Society of Nephrology,2004, 2004Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28731 (URN)13903 (Local ID)13903 (Archive number)13903 (OAI)
Available from: 2009-10-09 Created: 2009-10-09
Uhlin, F., Fridolin, I., Lindberg, L.-G. & Magnusson, M. (2003). Estimation of delivered dialysis dose by on-line monitoring of the ultraviolet absorbance in the spent dialysate. American Journal of Kidney Diseases, 41(5), 1026-1036
Open this publication in new window or tab >>Estimation of delivered dialysis dose by on-line monitoring of the ultraviolet absorbance in the spent dialysate
2003 (English)In: American Journal of Kidney Diseases, ISSN 0272-6386, E-ISSN 1523-6838, Vol. 41, no 5, p. 1026-1036Article in journal (Refereed) Published
Abstract [en]

Background:

Several methods are available to determine Kt/V, from predialysis and postdialysis blood samples to using on-line dialysate urea monitors or to ionic dialysance using a conductivity method. The aim of this study is to compare Kt/V calculated from the slope of the logarithmic on-line ultraviolet (UV) absorbance measurements, blood urea Kt/V, dialysate urea Kt/V, and Kt/V from the Urea Monitor 1000 (UM; Baxter Healthcare Corp, Deerfield, IL).

Methods:

Thirteen uremic patients on chronic thrice-weekly hemodialysis therapy were included in the study. The method uses absorption of UV radiation by means of a spectrophotometric set-up. Measurements were performed on-line with the spectrophotometer connected to the fluid outlet of the dialysis machine; all spent dialysate passed through a specially designed cuvette for optical single-wavelength measurements. UV absorbance measurements were compared with those calculated using blood urea and dialysate urea, and, in a subset of treatments, the UM.

Results:

Equilibrated Kt/V (eKt/V) obtained with UV absorbance (eKt/Va) was 1.19 ± 0.23; blood urea (eKt/Vb), 1.30 ± 0.20, and dialysate urea (eKt/Vd), 1.26 ± 0.21, and Kt/V in a subset measured by the UM (UM Kt/V) was 1.24 ± 0.18. The difference between eKt/Vb and eKt/Va was 0.10 ± 0.11, showing a variation similar to the difference between eKt/Vb and eKt/Vd (0.03 ± 0.10) and in a subset between eKt/Vb and UM Kt/V (−0.02 ± 0.11).

Conclusion:

The study suggests that urea Kt/V can be estimated by on-line measurement of UV absorption in the spent dialysate.

Keywords
Hemodialysis (HD), dialysis monitoring, dialysis dose, spectrophotometry, absorption, ultraviolet (UV), solute removal, spent dialysate, dialysis adequacy, dialysis efficiency, urea, Kt/V
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14191 (URN)10.1016/S0272-6386(03)00200-2 (DOI)
Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2017-12-13
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