On-line monitoring of electrolytes in hemodialysis: on the road towards individualizing treatment
article
Introduction: End-stage renal disease (ESRD) patients depend on dialysis for removal of toxic waste products, fluid overload relief and maintenance of electrolyte balance. Dialysis prolongs millions of lives. To some extent, ESRD has become a manageable disease with a steadily growing dialysis population of increasing average age and associated comorbidity. During 7 decades many technical refinements have been developed e.g. sodium profiling, blood volume, ultrafiltration variation based on blood pressure measurement, urea kinetics etc. Despite its large potentials, in-line electrolyte monitoring lags behind in dialysis treatment. Areas covered: In this paper, we review the state of technologies available for in-line monitoring of the electrolytes sodium, potassium and calcium during hemodialysis. Expert commentary: We concluded that individual optimization of dialysate composition should be able to improve hard medical outcomes, but practical clinical implementation stands/falls with reliable and affordable in-line ion-selective sensing technology. Optical ion-selective microsensors and microsystems form a promising pathway for individualizing the dialysis treatment. © 2016 The Author(s)
Topics
ConductivityDialysisDialysis doseElectrolyte balanceOptical sensorUrea monitorsBlood pressureElectric conductivityElectrolytesHemodialyzersMetabolismMicrofluidicsMicrosystemsOptical sensorsToxic materialsVoltage measurementBlood volumesCo morbiditiesDialysatesEnd-stage renal disease patientsIn-line monitoringOnline monitoringSelective sensingWaste products
TNO Identifier
573291
ISSN
17434440
Source
Expert Review of Medical Devices, 13(10), pp. 933-943.
Publisher
Taylor and Francis
Pages
933-943
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