Can Removal of Middle Molecular Uremic Retention Solutes be Estimated by UV-absorbance Measurements in Spent Dialysate?

The objectives of this study were: (1) to compare removal of the middle molecular (MM) and small uremic retention solutes; (2) to investigate if MM removal can be assessed by UV-absorbance at the wavelength of 297 nm during various dialysis treatment modalities. Seven uremic patients, four females and three males, mean age 58.1 +/- 8.7 years, were included into the study during 28 chronic hemodialysis sessions. A parameter, reduction ratio (RR) in percentage, was calculated for a small uremic retention solute urea, for a MM retention solute beta2-microglobulin (B2M), and for UV-absorbance at the wavelength of 297 during different dialysis modalities: conventional hemodialysis (HD), high flux hemodialysis (HF-HD), and postdilutional online hemodiafiltration (HDF) with different parameter settings. Achieved results were compared regarding mean values and SD, and by systematic and standard errors (BIAS +/- SE). It was found that RR is similar for small and MM uremic retention solutes in case of dialysis modality with the highest convective transport, HDF (78.9 +/- 8.1% for urea and 78.1 +/- 6.8% for B2M, N=7). Moreover, RR of small uremic retention solutes can be estimated with sufficient accuracy by UV-absorbance at 297 nm in the spent dialysate for all modalities (BIAS +/- SE: 1.7 +/- 4.0%, N=28), and for MM uremic retention solutes only for HDF (BIAS +/- SE: 1.1 +/- 7.1%, N=7). The results should be confirmed by appropriate kinetic modeling in the next studies.

Luman, M.Tallinn University of Technology, Estonia; North Estonian Medical Centre, Estonia (author)
Holmar, J.Tallinn University of Technology, Estonia (author)
Tomson, R.Tallinn University of Technology, Estonia (author)
Kalle, S.Tallinn University of Technology, Estonia (author)
Arund, J.Tallinn University of Technology, Estonia (author)
Uhlin, FredrikLinköpings universitet,Institutionen för medicin och hälsa,Medicinska fakulteten,Region Östergötland, Njurmedicinska kliniken US,Tallinn University of Technology, Estonia(Swepub:liu)freuh89 (author)
Fridolin, I.Tallinn University of Technology, Estonia (author)
Tallinn University of Technology, EstoniaTallinn University of Technology, Estonia; North Estonian Medical Centre, Estonia (creator_code:org_t)

In:WORLD CONGRESS ON MEDICAL PHYSICS AND BIOMEDICAL ENGINEERING, 2015, VOLS 1 AND 2Cham : Springer, s. 1297-130097833191938789783319193861

By the author/editor: Lauri, K.; Luman, M.; Holmar, J.; Tomson, R.; Kalle, S.; Arund, J.; show more...; Uhlin, Fredrik; Fridolin, I.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Radiology Nuclea ...

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