Estimation of delivered dialysis dose by on-line monitoring of the ultraviolet absorbance in the spent dialysate

Uhlin, Fredrik; Fridolin, Ivo; Lindberg, Lars‐Göran; Magnusson, Martin

doi:10.1016/s0272-6386(03)00200-2

Cited by 51 publications

(51 citation statements)

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“…The RR for online UV absorbance is lower compared to urea. Considering that RR (URR) is correlated to Kt/V (NKF-DOQI, 2006), this tendency is reported earlier, as the dialysis dose estimated by online UV absorbance was lower than Kt/V urea (Uhlin, 2003). The difference between the RR of all HPLC peaks in serum and online UV absorbance measurement (at 280 nm) in spent dialysate could be due to different chromophores in the serum and spent dialysate and because the serum was collected before and the dialysate sample 10 minutes after the start of dialysis.…”

Section: Discussionsupporting

confidence: 53%

“…However, the studies of relations between UV and small water soluble molecules such as urea and uric acid indicated that the wavelength of 280 nm may be preferred for online measurements when small water soluble molecules should be estimated. On this wavelength a relatively strong linear relationship exists between UV absorbance and concentrations of urea, creatinine and uric acid (Fridolin, 2002;Uhlin, 2003). While the contribution of uric acid forms a considerable part of the total area of HPLC peaks, uric acid plays an important role in online UV absorbance dialysis dose monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it seems that the UV-absorbing solutes can be subject to similar corrections regarding distribution volume and intercompartmental equilibration rates, similar to urea, although not with exactly the same distribution and equilibration intercompartmental rates in the body as urea. This makes it possible to estimate the delivered dialysis dose in terms of Kt/V by monitoring UV absorbance in spent dialysate online (Uhlin, 2003). The RR of creatinine demonstrates a high correlation for RR at 280 nm in both serum and spent dialysate.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Optical Dialysis Adequacy Monitoring: Small Uremic Toxins and Contribution to UV-Absorbance Studied by HPLC

Lauri¹,

Arund²,

Holmar³

et al. 2011

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Optical Dialysis Adequacy Monitoring: Small Uremic Toxins and Contribution to UV-Absorbance Studied by HPLC

Lauri¹,

Arund²,

Holmar³

et al. 2011

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

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“…Methodologically, these systems either rely on ionic dialysance measurement, which is closely related to urea clearance, or they monitor solute concentrations in the spent dialysate [2]. An innovative optical method determines the concentration of cleared waste solutes by measuring UV absorbance of the dialysate [3]. The close correlation between dialysate UV absorbance and the removal of urea allows continuous calculation of Kt/V values [4].…”

Section: Introductionmentioning

confidence: 99%

Online Kt/V Monitoring in Haemodialysis by UV Absorbance: Variations during Intra-Dialytic Meals

et al. 2014

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Background/Aims: The aim of this study was to analyse if intra-dialytic food intake may lead to changes in online Kt/V. Methods: Forty patients were analysed using haemodialysis machines with integrated online Kt/V monitoring based on UV absorbance or ionic dialysance. Kt/V was monitored before, during and after food intake. Samples of dialysate were analysed for urea, uric acid, creatinine and glucose levels. Results: Food intake was associated with a significant decrease in relative Kt/V when determined by UV absorbance. The drop in Kt/V was independent of changes in blood pressure or body posture. No significant changes in online Kt/V were found using the ionic dialysance method. Dialysate samples showed a continuous clearance of urea, uric acid and creatinine during meals but a rapid increase in glucose. Conclusion: Our data suggest that the short meal-associated decrease in online Kt/V as measured by UV absorbance does not represent a true decline in Kt/V but might reflect an intermittent increase in UV-absorbing dialysed solutes.

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“…Non-invasive sensors are particularly useful to avoid the expense of disposable material and probes [16], [18], [20], [21]. Optical sensors are mainly used for the purpose of relative blood volume (RBV) estimation [22], [23], but other uses have also been proposed [16], [17], [19], [24], [25].…”

Section: B Optical Sensors In Hemodialysis and Hemofiltrationmentioning

confidence: 99%

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

Visotti¹,

Ravagli

Perazzini³

et al. 2018

IEEE Sensors J.

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Abstract-Hemofiltration (HF) is a group of blood purification therapies used to treat patients with kidney injury. HF works using a process called ultrafiltration (UF) that removes excess liquid accumulated in the patient's body caused by lack of excretion. UF progress is monitored by the HF machine, but the state-of-the-art method is cumbersome and could be more accurate. In this work, a system composed by two optical sensors is proposed for real-time non-invasive estimation of ultrafiltration rate. This new system is simple, rugged, low-cost and operates on sound theoretical foundations. The sensor system has been tested with two different experimental protocols and showed good correlation between its output and the reference value of the ultrafiltration rate (R 2 =0.97), as well as improved accuracy compared to the available commercial machine (≃12ml/h). This system also has the potential to simplify the architecture required by critical care blood purification machines to perform UF control.Index Terms -Biomedical Measurement, Blood, Blood Purification, Hemofiltration, Hemoglobin, Measurement, Optical Sensor, Ultrafiltration I. INTRODUCTIONRenal replacement therapies (RRTs) have been developed to treat individuals affected by kidney failure, known as nephropathic patients. RRTs have the following targets:• Removal of excess fluid accumulated by the patient due to lack of kidney excretion.• Re-balancing concentration of specific substances in blood, for example electrolytes such as sodium.• Removal of the toxic by-products of metabolism, such as urea.Several types of therapies and machines have been developed. The main distinction of therapies is between those developed † First two authors A. Visotti and E. Ravagli contributed equally to this work. A. Visotti, C. Perazzini, D. Drudi, and C. Ghidini are with the company IBD Srl (https://www.ibdsrl.com/), Forlì, Italy.E. Ravagli and S. Severi* are with the Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy (e-mail: stefano.severi@unibo.it).to treat patients with acute kidney injury (AKI), who are expected to partially or fully regain kidney functionality, and those for patients with chronic kidney disease (CKD), who require periodic treatment for the rest of their lives or until kidney transplant. Therapies such as hemodialysis [1]-[3] and peritoneal dialysis [4] are the standard for CKD patients; while for AKI, slow, prolonged, one-time treatments are chosen to perform blood purification until kidney function is regained [5]- [7]. The effect of RRTs on the patient has been studied both clinically and with mathematical tools such as kinetic models, developed to describe the transfer of water and solutes across body compartments during .This work represents a technological improvement for AKI therapies where fluid removal is the main target -therapies also known as hemofiltration (HF). Fluid removal is performed by means of a physical principle called ultrafiltration (UF) [11]-[13]. Example...

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Estimation of delivered dialysis dose by on-line monitoring of the ultraviolet absorbance in the spent dialysate

Cited by 51 publications

References 47 publications

Optical Dialysis Adequacy Monitoring: Small Uremic Toxins and Contribution to UV-Absorbance Studied by HPLC

Optical Dialysis Adequacy Monitoring: Small Uremic Toxins and Contribution to UV-Absorbance Studied by HPLC

Online Kt/V Monitoring in Haemodialysis by UV Absorbance: Variations during Intra-Dialytic Meals

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

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