Utilization of UV Absorbance for Estimation of Phosphate Elimination during Hemodiafiltration

Enberg, Per; Fridolin, Ivo; Holmar, Jana; Fernström, Anders; Uhlin, Fredrik

doi:10.1159/000341598

Cited by 10 publications

(7 citation statements)

References 39 publications

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“…Optical monitoring of hemodialysis has been considered as a beneficial and cost-effective alternative to traditional methods to assess the effectiveness of the dialysis procedure without the need of frequent blood sampling [ 20 ]. The optical monitoring possibility of the phosphate removal during dialysis has been suggested by Enberg et al [ 15 ]. This study included 11 patients and 33 dialysis sessions, while absorbance at a single wavelength was used.…”

Section: Discussionmentioning

confidence: 99%

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An Optical Method for Serum Calcium and Phosphorus Level Assessment during Hemodialysis

Holmar

Uhlin

Fernström

et al. 2015

Toxins

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Survival among hemodialysis patients is disturbingly low, partly because vascular calcification (VC) and cardiovascular disease are highly prevalent. Elevated serum phosphorus (P) and calcium (Ca) levels play an essential role in the formation of VC events. The purpose of the current study was to reveal optical monitoring possibilities of serum P and Ca values during dialysis. Twenty-eight patients from Tallinn (Estonia) and Linköping (Sweden) were included in the study. The serum levels of Ca and P on the basis of optical information, i.e., absorbance and fluorescence of the spent dialysate (optical method) were assessed. Obtained levels were compared in means and SD. The mean serum level of Ca was 2.54 ± 0.21 and 2.53 ± 0.19 mmol/L; P levels varied between 1.08 ± 0.51 and 1.08 ± 0.48 mmol/L, measured in the laboratory and estimated by the optical method respectively. The levels achieved were not significantly different (p = 0.5). The Bland-Altman 95% limits of agreement between the two methods varied from −0.19 to 0.19 for Ca and from −0.37 to 0.37 in the case of P. In conclusion, optical monitoring of the spent dialysate for assessing the serum levels of Ca and P during dialysis seems to be feasible and could offer valuable and continuous information to medical staff.

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Section: Discussionmentioning

confidence: 99%

“…Methods for optical estimation of dialysis quality [ 10 ] and small [ 11 , 12 ], protein bound [ 13 ] and middle [ 14 ] molecular weight uremic retention solutes removal during dialysis has been proposed. Possibility for optical determination of phosphate elimination during dialysis has been also demonstrated [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

An Optical Method for Serum Calcium and Phosphorus Level Assessment during Hemodialysis

Holmar

Uhlin

Fernström

et al. 2015

Toxins

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“…For the determination of UV-absorbance (A) in the spent dialysate/ultrafiltrate, described earlier [9][10][11] , a double-beam spectrophotometer (V-570, UV/VIS/NIR spectrophotometer and software version 1.53.01 for Windows, JASCO Corp., Japan) with an accuracy of ±0.3% was used. Scanning at the UV-range 190-400 nm was performed after each session using pure dialysate as reference.…”

Section: Uv-absorbance Scanningmentioning

confidence: 99%

“…Our group has previously shown possibilities to estimate the removal of small water soluble waste solutes during HD, utilizing UV-absorbance within a wavelength range of 280-297 nm [8][9][10] . Since urea certainly is not a representative for all removed solutes, and is known to be rather non-toxic, an optical monitoring technique that is suitable for middle molecule removal could be a valuable complement to urea-based dialysis dose parameters.…”

Section: Introductionmentioning

confidence: 99%

Optical Estimation of Beta 2 Microglobulin during Hemodiafiltration - Does It Work?

et al. 2015

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Background: Currently, urea reduction seems to be the most widely used dialysis dose parameter. The aim of this study was to investigate the possibility to monitor beta 2-microglobulin (β2-M) elimination by utilizing the ultraviolet (UV) absorbance of spent dialysate. Methods: Blood and spent dialysate were collected during two week's sessions in 8 patients, one week in hemodialysis (HD) and one in hemodiafiltration (HDF). Correlation analysis between UV-wavelengths and concentrations of solutes in spent dialysate was performed. The reduction ratio (RR) of concentrations in blood, dialysate and UV-absorbance were compared. Results: Differences between HD and HDF were discovered in wavelength correlation maxima for the solutes. Relative error in RR (%) was larger (p < 0.05) for β2-M than for the other solutes. The most reasonable explanation is that β2-M does not absorb UV-radiation; instead, the absorbance of surrogate substances is measured. Conclusion: A high correlation between UV-absorbance and β2-M can be achieved for HDF but not for HD. Still, UV-absorbance could perhaps be used in solely HDF mode for estimation of β2-M removal.

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“…While ultraviolet (UV) absorbance monitoring of the spent dialysate [4][5][6] enables determining urea-based dialysis quality parameters [7,8], the potential of optical dialysis monitoring is wider. Earlier Toxins 2021, 13, 255 2 of 15 research has shown the potential of optical monitoring of the spent dialysate to estimate the removal of low molecular weight uremic toxins [9][10][11][12][13][14], elimination of electrolytes, such as phosphate and calcium, [15,16], and possibly for nutrition assessment [17]. As a result, the UV monitoring of the removal of low molecule weight uremic solutes by HD treatment has become commonly applied in the treatment practice worldwide [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate

Paats

Adoberg

Arund

et al. 2021

Toxins

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Optical monitoring of spent dialysate has been used to estimate the removal of water-soluble low molecular weight as well as protein-bound uremic toxins from the blood of end stage kidney disease (ESKD) patients. The aim of this work was to develop an optical method to estimate the removal of β2-microglobulin (β2M), a marker of middle molecule (MM) uremic toxins, during hemodialysis (HD) treatment. Ultraviolet (UV) and fluorescence spectra of dialysate samples were recorded from 88 dialysis sessions of 22 ESKD patients, receiving four different settings of dialysis treatments. Stepwise regression was used to obtain the best model for the assessment of β2M concentration in the spent dialysate. The correlation coefficient 0.958 and an accuracy of 0.000 ± 0.304 mg/L was achieved between laboratory and optically estimated β2M concentrations in spent dialysate for the entire cohort. Optically and laboratory estimated reduction ratio (RR) and total removed solute (TRS) of β2M were not statistically different (p > 0.35). Dialytic elimination of MM uremic toxin β2M can be followed optically during dialysis treatment of ESKD patients. The main contributors to the optical signal of the MM fraction in the spent dialysate were provisionally identified as tryptophan (Trp) in small peptides and proteins, and advanced glycation end-products.

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Utilization of UV Absorbance for Estimation of Phosphate Elimination during Hemodiafiltration

Cited by 10 publications

References 39 publications

An Optical Method for Serum Calcium and Phosphorus Level Assessment during Hemodialysis

An Optical Method for Serum Calcium and Phosphorus Level Assessment during Hemodialysis

Optical Estimation of Beta 2 Microglobulin during Hemodiafiltration - Does It Work?

Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate

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