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Journal Biomedical Radioelectronics №11 for 2013 г.
Article in number:
Investigation of the kinetics of uremic markers elimination during hemodialysis by dual-wavelength spectrometry
Keywords: hemodialysis chronic renal failure ultraviolet spectrophotometry monitoring uric acid uremic markers
Authors:
A.M. Vasilevsky - Dr.Sc. (Eng.), Professor, Saint Petersburg Electrotechnical University «LETI» n.a. V.I. Ulyanov (Lenin). E-mail: amvasilevsky@mail.ru
K.A. Vishnevsky - Mariinsky City Hospital, Saint-Petersburg, Russia. E-mail: mercucio_fh@mail.ru
A. Yu. Zemchenkov - Ph.D. (Med.), Mariinsky City Hospital, Saint-Petersburg, Russia. E-mail: zau@mail.wplus.net
A. V. Komashnya - Ph.D. (Med.), Associate Professor, Saint Petersburg State Medical University n. a. I.P.Pavlov. E-mail: artekomo@mail.ru
G. A. Konoplev - Ph.D. (Eng.), Associate Professor, Saint Petersburg Electrotechnical University «LETI» n.a. V.I. Ulyanov (Lenin). E-mail: gakonoplev@mail.ru
O.S. Stepanova - Junior Research Scientist, Saint Petersburg Electrotechnical University «LETI» n.a. V.I. Ulyanov (Lenin). E-mail: oksana_lopatenko@mail.ru
A.M. Tuchkova - Post-graduate Student, Department of Biotechnical Systems, Saint-Petersburg Electrotechnical University «LETI» n.a. V.I. Ulyanov (Lenin). E-mail: sandrin_a@mail.ru
Aleksandr Frorip - Ph.D., Eng. Director LDIAMON AS (Tartu, Estonia). E-mail: aleksandr@ldiamon.eu
Abstract:
Hemodialysis (HD) is an extracorporeal blood purification method, which is used to remove low-molecular weight waste products and excessive water from patients with renal failure. The treatment is carried out using dialysis machines ("artificial kidney"). Adequacy (efficiency) of HD is usually estimated from the amount of uremic markers eliminated during a HD session that is calculated by special mathematical models from the results of blood tests taken at the beginning and the end of the session. It is known that this approach has limited prognostic ability. A novel bispectral method and an optoelectronic sensor based on UV LEDs for real-time monitoring of hemodialysis have been developed. The method is based on on-line measuring of the spectral absorption of effluent dialysate in two quasi-monochromatic areas of UV region and subsequent calculation of uric acid concentration in dialysate. The system allows experimental investigation of uric acid elimination during HD treatment Clinical trials of the system showed that the character of temporal profiles and the absolute values of elimination rate for uric acid vary sufficiently between different patients possibly due to the patients` individual features and the parameters of HD treatment. The temporal dependences of elimination rate for uric acid can be approximated by the sum of two exponential functions. It is well predicted in the framework of the two-pool model of uremic markers elimination: the first exponential term describes transfer from blood to dialysate, the second - transfer from intracellular fluid to blood. Comprehensive analysis and interpretation of these results take additional research, which will probably help to improve and complete existing models of uremic markers kinetics.
Pages: 38-42
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