Automatic determination of Ca2+ during acute renal care hemodialysis

Regional anticoagulation by citrate.

Patients, with chronic kidney malfunction, are typically treated with a four-hour dialysis three times a week, while an acute patient is dialysed continuously for several days.

During the dialysis process, blood is pumped out of the patient into the dialysis treatment system. Before entering the dialysis’ hemofilter, a citrate solution is infused to decrease the concentration of ionized calcium (Ca2+) and thereby decrease the tendency for the blood to coagulate. The challenge is to determine the Ca2+-concentration within the system by employment of an in-line Ca2+-sensor, and then control the amount of citrate infusion. The determination of the Ca2+-concentration should be robust, accurate and precise as further described below.

Expected characteristics:

• Accuracy as Clin Lab within target range
• Measurement time: few minutes
• Operational life >72 h if disposable otherwise months
• No risk for contamination – preferably contactless
• Minimum of maintenance and operational skills
• Self-check/ supervision
• Applicable to the clinical situation (size, environment…)

• Technology extendable to bicarbonate, Mg2+, pH…? -Cost…