| Theme |
Monitoring Technologies in Dialysis Therapy |
| Title |
CSEM (continuous syringe extraction method) for the evaluation of hemodialysis -- Principles and applicabilities |
| Author |
Ichirou Masaki |
Kodaira, Kitaguchi Clinic |
| Author |
Masao Tsuchiya |
Kodaira, Kitaguchi Clinic |
| Author |
Katsuaki Fujino |
Kodaira, Kitaguchi Clinic |
| Author |
Takako Omori |
Kodaira, Kitaguchi Clinic |
| Author |
Kazuho Miyazaki |
Kodaira, Kitaguchi Clinic |
| Author |
Eisei Noiri |
Kodaira, Kitaguchi Clinic / First Department of Medicine, The University of Tokyo |
| [ Summary ] |
The adequacy of hemodialysis has been evaluated by Kt/V after making complicated formula calculations. However it was conceivable that the major drawback to conventional urea, kinetic modelling was the requirement of precise measurements of parameters at a single point. Dialyzer clearance (KD) was the most difficult parameter to measure accurately since KD was very sensitive to blood flow rate, clot formation and flow maldistributions.
Measurement of the net amount of solute removal is an alternative approach in the evaluation of dialysis adequacy, but it was considered to be impractical because of the spent dialysate volume over 120l. We proposed the continuous syringe extraction method (CSEM) as a reasonably convenient method for the evaluation of solute removal. CSEM is more versatile and its applicability is not limited to the evaluation of urea removal, but also useful for the direct monitoring of filterability of novel uremic toxins in dialysate ultrafiltrate, and also suitable for detection of particular viruses in the spent dialysate. This review addresses the mechanism and representative applications, such as dialyzer comparison, protein catabolic rate analysis, and the HCV escape issue. |