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, 1026-1036 p.Article in journal (Refereed) Published
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).
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.
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).
The study suggests that urea Kt/V can be estimated by on-line measurement of UV absorption in the spent dialysate.
Place, publisher, year, edition, pages
2003. Vol. 41, no 5, 1026-1036 p.
Hemodialysis (HD), dialysis monitoring, dialysis dose, spectrophotometry, absorption, ultraviolet (UV), solute removal, spent dialysate, dialysis adequacy, dialysis efficiency, urea, Kt/V
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-14191DOI: 10.1016/S0272-6386(03)00200-2OAI: oai:DiVA.org:liu-14191DiVA: diva2:22874