ArticleClinical kidney journal2018
Interventions to improve hemodialysis adequacy: protocols based on real-time monitoring of dialysate solute clearance.
Article in Clinical kidney journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Real-Time Dialysis Dose: Ionic Dialysis Versus Classical Urea Kinetic Modeling Indices.Cureus · 2024Article
- Optical monitoring of hemodialysis using noninvasive measurement of uric acid in the dialysate.Scientific reports · 2023Article
- Time-averaged concentration estimation of uraemic toxins with different removal kinetics: a novel approach based on intradialytic spent dialysate measurements.Clinical kidney journal · 2023Article
- Ensuring hemodialysis adequacy by dialysis dose monitoring with UV spectroscopy analysis of spent dialyzate.The International journal of artificial organs · 2022Article
- Comparison of the Dialysis Adequacy Across Four Types of Dialysis Machines in Hemodialysis Patients.Iranian journal of nursing and midwifery researchArticle
- Intradialytic techniques for automatic and everyday access monitoring.Seminars in dialysisReview
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe monitoring of dialysate ultraviolet (UV) absorbance is a validated technology to measure hemodialysis adequacy and allows for continuous and real-time tracking every session as opposed to the typical once-monthly assessments. Clinical care guidelines are needed to interpret the findings so as to troubleshoot problematic absorbance patterns and intervene during an individual treatment as needed.
methodsWhen paired with highly structured clinical care protocols that allow autonomous nursing actions, this technology has the potential to improve treatment outcomes. These devices measure the UV absorbance of dialysate solutes to calculate and then display the delivered as well as predicted clearance for that session. Various technical factors can affect the course of dialysate absorbance, confound the device's readout of clearance results and thus lead to challenges for the dialysis unit staff to properly monitor dialysis adequacy. We analyze optimal and problematic patterns to the device's 'clearance' display (e.g. due to thrombosis of hollow fibers, inadequate access blood flow or recirculation) and provide specific interventions to ensure delivery of an adequate dialysis dose. A rigorous algorithm is presented with representative device monitor display profiles from actual hemodialysis sessions. Procedural rationale and interventions are described for each individual scenario.
conclusionReal-time hemodialysate UV absorbance patterns can be used for protocol-based intradialytic interventions to optimize solute clearance.
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