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  • 1.
    Andersson, Roger
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Fridolin, Ivo
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Magnusson, Martin
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
    Ask, Per
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Analysis of the relationship between UV-absorbance of solute contents during a dialysis sessionManuscript (preprint) (Other academic)
    Abstract [en]

    In this paper, the influence from patient anamnesis and haemodialysis session specifications onto the relationship between obtained ultra violet (UV) absorbance and urea concentration in the spent dialysate were discussed. A characterisation of the relationship was done by an intercept value and a slope. Recently, a new a dialysate monitoring device, using UV- absorbance, been developed by our group which has found a relationship between the UV- absorbance and waste products in the dialysate but this relationship vary between patients. In the present investigation, 13 patients performing totally 84 sessions were characterised using 31 possible affecting parameters. Using a multi-regression analysis 11 parameters were found significant as affecting parameters. In a novel mathematical model approach the obtained UV- absorbance and incorporating possible affecting parameters we could predict urea concentration from the UV-absorption in the spent dialysate in the total material of patients and dialysis sessions. For all the 84 sessions R2 between 0.938 and 0.996 were obtained. A performed analysis of variance rejects the assumption of equal conditions for the relationship between diabetics and non-diabetics patients in the material (F=5.2 for intercept and F=14.4 for slope). The urea concentration could be estimated with an accuracy of 11% (one standard deviation) which is normally clinically sufficient. The non-invasive UV -absorption method therefore seems to have great potential for monitoring and control haemodialysis sessions.

  • 2.
    Fridolin, Ivo
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Magnusson, Martin
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    On-line monitoring of solutes in dialysate using adsorption of ultraviolet radiation: technical description2002In: International Journal of Artificial Organs, ISSN 0391-3988, E-ISSN 1724-6040, Vol. 25, no 8, p. 748-761Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    The aim of this work was to describe a new optical method for monitoring solutes in a spent dialysate using absorption of UV radiation.

    METHOD:

    The method utilises UV-absorbance determined in the spent dialysate using a spectrophotometrical set-up. Measurements were performed both on collected dialysate samples and on-line. During on-line monitoring, a spectrophotometer was connected to the fluid outlet of the dialysis machine, with all spent dialysate passing through a specially-designed cuvette for optical single-wavelength measurements. The concentrations of several substances of various molecular sizes, electrical charge, transport mechanism, etc. were determined in the dialysate and in the blood using standard laboratory techniques. The correlation coefficient between UV-absorbance of the spent dialysate and concentration of the substances in the spent dialysate and in the blood was calculated from data based on the collected samples.

    RESULTS:

    The obtained on-line UV-absorbance curve demonstrates the possibility to follow a single hemodialysis session continuously and to monitor deviations in the dialysator performance using UV-absorbance. The experimental results indicate a very good correlation between UV-absorbance and several small waste solutes removed such as urea, creatinine and uric acid in the spent dialysate and in the blood for every individual treatment at a fixed wavelength of 285 nm. Moreover, a good correlation between the UV-absorbance and substances like potassium, phosphate and beta2-microglobulin was obtained. The lowest correlation was achieved for sodium, calcium, glucose, vitamin B12 and albumin.

    CONCLUSIONS:

    A technique for on-line monitoring of solutes in the spent dialysate utilising the UV-absorbance was developed. On-line monitoring during a single hemodialysis session exploiting UV-absorbance represents a possibility to follow a single hemodialysis session continuously and monitor deviations in dialysis efficiency (e.g. changes in blood flow and clearance). The UV-absorbance correlates well to the concentration of several solutes known to accumulate in dialysis patients indicating that the technique can be used to estimate the removal of retained substances.

  • 3.
    Haarhaus, Mathias
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
    Fernström, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Magnusson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Evaluation of bio-intact (1-84) parathyroid hormone, vitamin D status and bond mineral density in patients with predialysis chronic renal failure2004In: ASN Renal Week,2004, 2004Conference paper (Other academic)
  • 4.
    Haarhaus, Mathias
    et al.
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Nephrology.
    Fernström, Anders
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
    Magnusson, Martin
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Clinical significance of bone alkaline phosphatase isoforms, including the novel B1x isoform, in mild to moderate chronic kidney disease2009In: NEPHROLOGY DIALYSIS TRANSPLANTATION, ISSN 0931-0509, Vol. 24, no 11, p. 3382-3389Article in journal (Refereed)
    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.

  • 5.
    Magnusson, Martin
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Department of Molecular and Clinical Medicine, Medical Microbiology. Linköping University, Faculty of Health Sciences.
    Experimental studies of small intestinal permeability and function in uremia1991Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The intestinal permeability has been investigated in experimental chronic and acute uremia in rats. The permeability and the mucosal ability to exclude larger molecules have been measured using differently sized polyethylene glycols (PEG 400 and 1000: mean weights of 400 and 1000 dalton, range 326-1162 dalton). The permeation (uptake) of the differently sized molecules has been estimated from the urinary recovery of the PEGs after oral administration of the permeability markers. The effects of two different diets (high-and low-protein) have been studied inexperimental chronic uremia and in normal rats. The renal excretion of the PEGs after intravenous administration has also been investigated in chronic uremic rats. Furthermore, the effect of experimental acute uremia on intestinal brush border peptidases, disaccharidases and mucosal morphology have been studied. Finally has the urinary recovery of PEGs been investigated in patients with renal insufficiency compared to healthy subjects.

    The urinary recovery of PEGs was reduced after intravenous administration in chronic uremic rats. The relative excretion of the smaller PEGs was, however, increased compared to the larger ones in the uremic rats. The opposite was found in the control rats. Intestinal permeability, measured as an increased urinary recovery after oral administration of larger PEGs, was increased in chrortic uremic rats.

    The overall urinary recovery of the PEG molecules was reduced in patients with renal insufficiency. However, the relative excretion of the differently sized PEGs indicated a relative increased uptake of larger molecules also in uremic patients suggesting a more permeable gut.

    An opposite pattern was seen in experimental acute uremic rats, reduced urinary recovery along with a relative decreased excretion of larger molecules compatible with a less permeable gut.

    Moreover, both in the chronic uremic and in the control rats treated with low-protein diet was a reduction of intestinal permeability seen.

    Increased activity of brush border peptidases was found in acute uremic rats. Minor morphological changes, shortening of the microvilli of the enterocytes in the small intestine were also observed. On the other hand, no alterations of the disaccharidases were measured.

    In conclusion, the change in intestinal permeability indicates a more leaky mucosal barrier in chronic uremia. Functional alterations i.e. increased peptidase activity was seen in acute uremic rats. A more leaky gut might allow potentially toxic, infectious and immunogenic substances to pass more freely over the mucosa in chronic uremia.

  • 6.
    Magnusson, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
    Davie, Michael W J
    Sharp, Christopher A
    Isoforms of bone alkaline phosphatase: carachterization and origin in human trabecular and cortical bone.1999In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 14, p. 1926-1933Article in journal (Refereed)
  • 7.
    Sennfält, Karin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
    Carlsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society.
    Comparison of hemodialysis and peritoneal dialysis - A cost-utility analysis2002In: Peritoneal Dialysis International, ISSN 0896-8608, E-ISSN 1718-4304, Vol. 22, no 1, p. 39-47Article in journal (Refereed)
    Abstract [en]

    ? Objective: Our aim was to compare both health-related quality of life and costs for hemodialysis (HD) and peritoneal dialysis (PD) in a defined population. ? Design: Decision-tree modeling to estimate total costs and effects for two treatment strategies, HD and PD, among patients with chronic kidney failure, for 5 years following the start of treatment. Courses of events and health-care consumption were mapped in a retrospective matched-record study. Data on health status were obtained from a matched population by a quality-of-life questionnaire (EuroQol). The study has a societal perspective. ? Setting: All dialysis departments in the southeastern health-care region of Sweden. ? Patients: 136 patients with kidney failure, comprising 68 matched pairs, were included in a retrospective record study, 81 patients with kidney failure, comprising 27 matched triplets, were included in a prospective questionnaire study. ? Main Outcome Measures: Cost per life year and cost per quality-adjusted life year. ? Results: The cost per quality-adjusted life year for PD was lower in all analyzed age groups. There was a 12% difference in the age group 21 - 40 years, a 31% difference in the age group 41 - 60 years, and an 11% difference in the age group 61+ years. Peritoneal dialysis and HD resulted in similar frequencies of transplantation (50% and 41%, respectively) and expected survival (3.58 years and 3.56 years, respectively) during the first 5 years after the initiation of treatment. ? Conclusion: The cost-utility ratio is most favorable for PD as the primary method of treatment for patients eligible for both PD and HD.

  • 8.
    Uhlin, Fredrik
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Fridolin, Ivo
    Tek.Univ Tallin.
    Lindberg, Lars-Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Clearance variation monitored by on-line UV-absorbance during haemodialysis2005In: Nordic Baltic Conference Biomedical Engineering and medical physics,2005, 2005Conference paper (Other academic)
  • 9.
    Uhlin, Fredrik
    et al.
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences.
    Fridolin, Ivo
    Centre of Biomedical Engineering, Tallinn Technical University, Tallinn, Estonia.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Magnusson, Martin
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Estimating total urea removal and protein catabolic rate by monitoring UV absorbance in spent dialysate2005In: Nephrology Dialysis Transplantation, ISSN 0931-0509, Vol. 20, no 11, p. 2458-2464Article in journal (Refereed)
    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.

  • 10.
    Uhlin, Fredrik
    et al.
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
    Fridolin, Ivo
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Magnusson, Martin
    Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
    Estimation of delivered dialysis dose by on-line monitoring of the ultraviolet absorbance in the spent dialysate2003In: American Journal of Kidney Diseases, ISSN 0272-6386, E-ISSN 1523-6838, Vol. 41, no 5, p. 1026-1036Article in journal (Refereed)
    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.

  • 11.
    Uhlin, Fredrik
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Fridolin, Ivo
    Lindberg, Lars-Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Icke-invasiv kontinuerlig övervakning av bloddialys UV absorption2004In: Njurmedicins regionmöte,2004, 2004Conference paper (Other academic)
  • 12.
    Uhlin, Fredrik
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Fridolin, Ivo
    Lindberg, Lars-Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Protein catabolic rate estimated by on-line monitoring of the UV-absorbance in the Spent Dialysate2004In: American Society of Nephrology,2004, 2004Conference paper (Other academic)
  • 13.
    Uhlin, Fredrik
    et al.
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences.
    Fridolin, Ivo
    Centre of Biomedical Engineering, Tallinn Technical University, Tallinn, Estonia.
    Magnusson, Martin
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Dialysis dose (Kt/V) and clearance variation sensitivity using measurement of ultraviolet-absorbance (on-line), blood urea, dialysate urea and ionic dialysance2006In: Nephrology Dialysis Transplantation, ISSN 0931-0509, Vol. 21, no 8, p. 2225-2231Article in journal (Refereed)
    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.

  • 14.
    Uhlin, Fredrik
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Fridolin, Ivo
    Tek.Univ Tallin.
    Magnusson, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Lindberg, Lars-Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Online monitoring of the spent dialysate during haemodialysis using UV absorbance2005In: European Dialysis Transplant nurse assosiation EDTNA,2005, 2005Conference paper (Refereed)
  • 15.
    Uhlin, Fredrik
    et al.
    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.
    Fridolin, Ivo
    Centre of Biomedical Engineering, Tallinn Technical University, Tallinn, Estonia.
    Magnusson, Martin
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Ultra violet absorbance on-line measurement utilized to monitor clinical events during haemodialysis2006In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 32, no 3, p. 141-146Article in journal (Refereed)
    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

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