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Adequacy of hemodialysis in acute kidney injury: Real‐time monitoring of dialysate ultraviolet absorbance vs. blood‐based Kt/Vurea
Author(s) -
VasquezRios George,
Zhang Frank,
Scott Mitchell G.,
Vijayan Anitha
Publication year - 2021
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12879
Subject(s) - medicine , hemodialysis , dialysis , urology , kt/v , blood urea nitrogen , surgery , kidney
Background Current guidelines recommend monitoring the adequacy of hemodialysis (HD) treatments in patients with acute kidney injury (AKI). Blood‐based methods for calculating urea such as reduction ratio (URR) and single‐pool Kt/Vurea (spKt/Vurea) require pre‐ and post‐HD blood urea nitrogen (BUN) measurements. This study aims to compare real‐time monitoring of urea clearance using dialysate ultraviolet absorbance (UV) with laboratory‐measured spKt/Vurea. Methods We conducted a single‐center, retrospective study among hospitalized patients with AKI, who required intermittent hemodialysis (IHD). Those patients whose dialysis dose was simultaneously monitored by spKt/Vurea and UV‐absorbance (UV‐spKt/Vurea) were included in the study. The statistical correlation between both methods was assessed by means of the Pearson moment product correlation, Mann–Whitney U‐test and Bland–Altman analysis of agreement. Results Thirty patients with AKI were evaluated. There was no statistical difference between the mean spKt/Vurea calculated by traditional methods and the mean UV‐spKt/Vurea. (1.37 ± 0.37 vs. 1.28 ± 0.36, P = 0.12, CI: 95%). A Pearson moment correlation analysis revealed a close agreement between both methods ( r = 0.79, P < 0.001). Furthermore, Bland–Altman analysis showed that >95% of the data points were confined within the upper and lower levels of agreement. Conclusion In this pilot study of patients with AKI, UV‐spKt/Vurea correlated with standard blood‐based spKt/Vurea and may be a useful tool to monitor dialysis adequacy. Larger studies evaluating multiple UV and blood‐based measurements per patient and a more diverse AKI population are needed to confirm this initial observation.