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Ultra violet absorbance on-line measurement utilized to monitor clinical events during haemodialysis
Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
Centre of Biomedical Engineering, Tallinn Technical University, Tallinn, Estonia.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
2006 (English)In: Journal of Renal Care, ISSN 1755-6678, Vol. 32, no 3, 141-146 p.Article 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

Place, publisher, year, edition, pages
2006. Vol. 32, no 3, 141-146 p.
Keyword [en]
dialysis adequacy; dialysis clearance; haemodialysis monitoring; on-line adjustments; ultra violet absorption
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-14194PubMedID: 17393808OAI: diva2:22877

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: 2012-09-20
In thesis
1. Haemodialysis Treatment Monitored On-line by Ultra Violet Absorbance
Open this publication in new window or tab >>Haemodialysis Treatment Monitored On-line by Ultra Violet Absorbance
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis describes and evaluates an optical method utilizing ultra violet (UV) absorbance for on-line monitoring of haemodialysis treatment. Increased efficiency of haemodialysis treatment is considered to correlate to decreased morbidity and mortality when urea clearance (Kt/V) is elevated. However, further improvements have not been achieved at a higher Kt/V. The mortally rate in the haemodialysis population is still high (27% in Sweden).

Urea as the clinical marker is under discussion, partly due to urea being non-toxic, but also that the uraemic syndrom is the result of a cumulative retention of innumerable involved compounds.

On-line monitoring systems based on urea determination for improved dialysis efficiency have been suggested and developed in different settings over the last two decades, but have not achieved worldwide utilisation as routine clinical equipment. This thesis demonstrates that the UV-technique utilising 280, 285 and 297 nm is capable of estimating dialysis efficiency in therms of Kt/V, nutritional status in terms of protein catabolic rate (PCR), with the same characteristics as existing methods. One novel finding using UV-absorbance with high sampling rates is the on-line visualisation of the clearance process for following variations in clearance caused by clinical events and disturbances as well as during and after adjustments. The fact that the UV-absorbance technique does not measure urea directly but has high correlation to several other both UV-absorbing and not-absorbing solutes makes it suitable to reflect a more overall solute retention process. Finally, a new efficiency parameter based on the calculation of the area under UV- curve (clearance curve), is suggested to reflect the total removal of some solutes.

In summary the UV-technique has the potential to be an additional tool to evaluate improvements of dialysis efficiency, which may result in decreased morbidity, longer life span and enhanced quality of life for the haemodialysis patients.

Place, publisher, year, edition, pages
Institutionen för medicin och vård, 2006
Linköping University Medical Dissertations, ISSN 0345-0082 ; 962
Dialysis, Hemodialysis, Proteins, Metabolism, Renal dialysis, Ultraviolet spectrophotometry, Urea, Uremia
National Category
Urology and Nephrology
urn:nbn:se:liu:diva-7987 (URN)91-85643-65-3 (ISBN)
Public defence
2006-11-10, Berzeliussalen, Campus US, Linköpings Universitet, Linköping, 09:00 (English)
Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2009-06-05

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Uhlin, FredrikFridolin, IvoMagnusson, MartinLindberg, Lars-Göran
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Internal MedicineFaculty of Health SciencesDepartment of Nephrology UHLDepartment of Medical and Health SciencesPhysiological MeasurementsThe Institute of Technology
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