Treatment with Paracetamol Can Interfere with the Intradialytic Optical Estimation in Spent Dialysate of Uric Acid but Not of Indoxyl Sulfate

Toxins (Basel). 2022 Sep 1;14(9):610. doi: 10.3390/toxins14090610.

Abstract

Optical online methods are used to monitor the haemodialysis treatment efficiency of end stage kidney disease (ESKD) patients. The aim of this study was to analyse the effect of the administration of UV-absorbing drugs, such as paracetamol (Par), on the accuracy of optical monitoring the removal of uremic toxins uric acid (UA) and indoxyl sulfate (IS) during standard haemodialysis (HD) and haemodiafiltration (HDF) treatments. Nine patients received Par in daily dosages 1−4 g for 30 sessions. For 137 sessions, in 36 patients the total daily dosage of UV-absorbing drugs was less than 500 mg, and for 6 sessions 3 patients received additional UV-absorbing drugs. Par administration slightly affected the accuracy of optically assessed removal of UA expressed as bias between optically and laboratory-assessed reduction ratios (RR) during HD but not HDF employing UV absorbance of spent dialysate (p < 0.05) at 295 nm wavelength with the strongest correlation between the concentration of UA and absorbance. Corresponding removal of IS based on fluorescence at Ex280/Em400 nm during HD and HDF was not affected. Administration of UV-absorbing drugs may in some settings influence the accuracy of optical assessments in spent dialysate of the removal of uremic solutes during haemodialysis treatment of ESKD patients.

Keywords: haemodialysis; indoxyl sulfate; optical monitoring; paracetamol; uric acid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen
  • Dialysis Solutions
  • Hemodiafiltration*
  • Humans
  • Indican
  • Kidney Failure, Chronic* / therapy
  • Renal Dialysis / methods
  • Uric Acid

Substances

  • Dialysis Solutions
  • Uric Acid
  • Acetaminophen
  • Indican

Grants and funding

The research was funded partly by the European Union through the European Regional Development Fund H2020-SMEINST-2-2017, OLDIAS2—Online Dialysis Sensor Phase2 project, Grant Agreement nr 767572, the Estonian Ministry of Education and Research under institutional research financing, grant nr IUT 19-2, and by Estonian Centre of Excellence in IT (EXCITE) funded by European Regional Development Fund. The Swedish study was partly supported by the collection Foundation, Njurfonden (2017 and 2018), Sweden.