THIS THESIS FOCUS ON A PATIENT GROUP that have multifactorial concerns as a consequence to their End Stage Renal Disease (ESRD): physically due to loss of kidney function, socially due to the time of dialysis treatment and psychologically due to the fact that suffering from a serious disease, with an uncertain future awakens existential concerns, with a high risk of complications and early death related both to disease and treatment.
This thesis describes and evaluates an optical method utilizing ultra violet (UV) absorbance for on-line monitoring of haemodialysis treatment. Increased efficiency of haemodialysis treatment is considered to correlate to decreased morbidity and mortality when urea clearance (Kt/V) is elevated…
Contents
Introduction
Background
The Kidney
Renal failure
Uraemia and its symptoms
Urea
Uraemic Toxins
Living with End Stage Renal Disease (ESRD)
Haemodialysis (HD)
Blood access
Transport of substances dialysis
The Dialysate
Haemodialysis complications
Dialysis adequacy
Total body water and compartment effects
On-line monitoring equipment
Urea monitors
Enzymatic sensorsdialysance
Electromagnetic radiation
Aims of thesis
Subjects
Ethics and normalization
The method of on-line monitoring of dialysis using absorption of ultra violet
radiation
Instrumentation during the studies
Choice of reference
Choice of wavelengths
Methodlogical tests and considerations
In vitro tests
Correlation to urea
Estimation of delivered dialysis dose (Papers I, III & V)
Sampling and laboratory analysis
Calculation of Kt/V
Sensitiveness of variation in dialysis clearance
Estimation of protein catabolic rate and total removed urea (Paper II)
Total dialysate collection
Estimation of TRU
PCR calculated from TRU clinical events by UV-absorbance (Paper III & IV)
Area under curve as a parameter for dialysis efficiency (PaperV)
General Discussion
Future and development
Summary and conclusions
Acknowledgements
References
Author: Uhlin, Fredrik
Source: Linköping University
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