Abstract
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.
Highlights
Mortality among end-stage renal disease (ESRD) patients is continuously very high
The aim of this study was to explore whether multi-wavelength algorithms based on optical properties, ultraviolet-absorbance (UV) and fluorescence (F) of the spent dialysate are an appropriate technique for estimating serum levels of Ca and P in chronic kidney disease (CKD) patients
The primary aim was to develop multi-wavelength algorithms based on the optical information of the spent dialysate for optical estimation of serum level trends of Ca and P
Summary
Mortality among end-stage renal disease (ESRD) patients is continuously very high. 52% of hemodialysis (HD) and 61% of peritoneal dialysis patients live for at least three years after the beginning of renal replacement therapy. One leading cause of death is cardiovascular disease (CVD) [1]. Vascular calcification is common in chronic kidney disease (CKD) patients, and one of the reasons is abnormal bone metabolism, resulting in high serum levels of calcium (Ca) and phosphorus (P) [2]. It has been shown that elevated phosphorus levels are independently associated with mortality in dialysis patients [3]. The Dialysis Outcomes and Practice Patterns Study (DOPPS) indicated that increased levels of serum Ca, Pa and PTH are related to increased all-cause and cardiovascular mortality [4]
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