Joaquim Casals , José Jesús Broseta , Rosa María Fernández , Diana Rodriguez-Espinosa , Jimena del Risco , Miquel Gómez , Lida M. Rodas , Marta Arias-Guillén , Manel Vera , Néstor Fontseré , Naira Rico , Francisco Maduell
{"title":"实验室测定的血浆钠与血液透析监测仪测定的血浆钠之间的相关性","authors":"Joaquim Casals , José Jesús Broseta , Rosa María Fernández , Diana Rodriguez-Espinosa , Jimena del Risco , Miquel Gómez , Lida M. Rodas , Marta Arias-Guillén , Manel Vera , Néstor Fontseré , Naira Rico , Francisco Maduell","doi":"10.1016/j.nefro.2023.09.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Changes in plasma sodium concentration (<sub>p</sub>Na, expressed in mEq/l) are common in hemodialysis (HD) patients. Hemodialysis monitors can estimate <sub>p</sub>Na by using an internal algorithm based on ionic dialysance measurements. The present study studies the accuracy of the correlation between the <sub>p</sub>Na estimated by the dialysis monitor and that measured by the biochemistry laboratory at our center.</p></div><div><h3>Material and methods</h3><p>A single-centre prospective observational study in patients on a chronic HD program with the 6008 CAREsystem monitor and standard sodium (138<!--> <!-->mEq/l) and bicarbonate (32<!--> <!-->mmol/l) prescriptions. Venous blood samples were drawn from each patient before and after each HD session to ensure inter- and intra-individual validity. The <sub>p</sub>Na was measured in the biochemistry laboratory using indirect potentiometry and simultaneously the estimated <sub>p</sub>Na by the HD monitor was recorded at the beginning and at the end of the HD session. For statistical analysis, a scatter plot was made, and Spearman's correlation quotient was calculated. In addition, the differences between both methods were represented as Bland-Altman diagrams.</p></div><div><h3>Results</h3><p>The pre-dialysis <sub>p</sub>Na measured in the laboratory was 137.49<!--> <!-->±<!--> <!-->3.3, and that of the monitor, 137.96<!--> <!-->±<!--> <!-->2.91, with a correlation with <em>R</em><sup>2</sup> value of 0.683 (<em>P</em><.001). The post-dialysis <sub>p</sub>Na measured in the laboratory was 137.08<!--> <!-->±<!--> <!-->2.23, and that of the monitor was 138.87<!--> <!-->±<!--> <!-->1.88, with an <em>R</em><sup>2</sup> of 0.442 (<em>P</em><.001). On the Bland-Altman plots, the pre-dialysis <sub>p</sub>Na has a systematic error of 0.49, in favor of the monitor-estimated <sub>p</sub>Na, with a 95% confidence interval (CI) of (−3.24 to a 4.22). In the post-dialysis <sub>p</sub>Na, a systematic error of 1.79 with a 95% CI of (−1.64 to 5.22) was obtained.</p></div><div><h3>Conclusion</h3><p>The correlation between the <sub>p</sub>Na estimated by Fresnius 6008 CAREsystem HD monitor and that measured by the laboratory is good, especially pre-dialysis measurements. Further studies should verify the external validity of these results.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001455/pdfft?md5=674d1cc66e024ca904a886eb140428a9&pid=1-s2.0-S0211699523001455-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Correlación entre el sodio plasmático determinado por el laboratorio y el determinado por el monitor de hemodiálisis\",\"authors\":\"Joaquim Casals , José Jesús Broseta , Rosa María Fernández , Diana Rodriguez-Espinosa , Jimena del Risco , Miquel Gómez , Lida M. Rodas , Marta Arias-Guillén , Manel Vera , Néstor Fontseré , Naira Rico , Francisco Maduell\",\"doi\":\"10.1016/j.nefro.2023.09.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Changes in plasma sodium concentration (<sub>p</sub>Na, expressed in mEq/l) are common in hemodialysis (HD) patients. Hemodialysis monitors can estimate <sub>p</sub>Na by using an internal algorithm based on ionic dialysance measurements. The present study studies the accuracy of the correlation between the <sub>p</sub>Na estimated by the dialysis monitor and that measured by the biochemistry laboratory at our center.</p></div><div><h3>Material and methods</h3><p>A single-centre prospective observational study in patients on a chronic HD program with the 6008 CAREsystem monitor and standard sodium (138<!--> <!-->mEq/l) and bicarbonate (32<!--> <!-->mmol/l) prescriptions. Venous blood samples were drawn from each patient before and after each HD session to ensure inter- and intra-individual validity. The <sub>p</sub>Na was measured in the biochemistry laboratory using indirect potentiometry and simultaneously the estimated <sub>p</sub>Na by the HD monitor was recorded at the beginning and at the end of the HD session. For statistical analysis, a scatter plot was made, and Spearman's correlation quotient was calculated. In addition, the differences between both methods were represented as Bland-Altman diagrams.</p></div><div><h3>Results</h3><p>The pre-dialysis <sub>p</sub>Na measured in the laboratory was 137.49<!--> <!-->±<!--> <!-->3.3, and that of the monitor, 137.96<!--> <!-->±<!--> <!-->2.91, with a correlation with <em>R</em><sup>2</sup> value of 0.683 (<em>P</em><.001). The post-dialysis <sub>p</sub>Na measured in the laboratory was 137.08<!--> <!-->±<!--> <!-->2.23, and that of the monitor was 138.87<!--> <!-->±<!--> <!-->1.88, with an <em>R</em><sup>2</sup> of 0.442 (<em>P</em><.001). On the Bland-Altman plots, the pre-dialysis <sub>p</sub>Na has a systematic error of 0.49, in favor of the monitor-estimated <sub>p</sub>Na, with a 95% confidence interval (CI) of (−3.24 to a 4.22). In the post-dialysis <sub>p</sub>Na, a systematic error of 1.79 with a 95% CI of (−1.64 to 5.22) was obtained.</p></div><div><h3>Conclusion</h3><p>The correlation between the <sub>p</sub>Na estimated by Fresnius 6008 CAREsystem HD monitor and that measured by the laboratory is good, especially pre-dialysis measurements. 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Correlación entre el sodio plasmático determinado por el laboratorio y el determinado por el monitor de hemodiálisis
Introduction
Changes in plasma sodium concentration (pNa, expressed in mEq/l) are common in hemodialysis (HD) patients. Hemodialysis monitors can estimate pNa by using an internal algorithm based on ionic dialysance measurements. The present study studies the accuracy of the correlation between the pNa estimated by the dialysis monitor and that measured by the biochemistry laboratory at our center.
Material and methods
A single-centre prospective observational study in patients on a chronic HD program with the 6008 CAREsystem monitor and standard sodium (138 mEq/l) and bicarbonate (32 mmol/l) prescriptions. Venous blood samples were drawn from each patient before and after each HD session to ensure inter- and intra-individual validity. The pNa was measured in the biochemistry laboratory using indirect potentiometry and simultaneously the estimated pNa by the HD monitor was recorded at the beginning and at the end of the HD session. For statistical analysis, a scatter plot was made, and Spearman's correlation quotient was calculated. In addition, the differences between both methods were represented as Bland-Altman diagrams.
Results
The pre-dialysis pNa measured in the laboratory was 137.49 ± 3.3, and that of the monitor, 137.96 ± 2.91, with a correlation with R2 value of 0.683 (P<.001). The post-dialysis pNa measured in the laboratory was 137.08 ± 2.23, and that of the monitor was 138.87 ± 1.88, with an R2 of 0.442 (P<.001). On the Bland-Altman plots, the pre-dialysis pNa has a systematic error of 0.49, in favor of the monitor-estimated pNa, with a 95% confidence interval (CI) of (−3.24 to a 4.22). In the post-dialysis pNa, a systematic error of 1.79 with a 95% CI of (−1.64 to 5.22) was obtained.
Conclusion
The correlation between the pNa estimated by Fresnius 6008 CAREsystem HD monitor and that measured by the laboratory is good, especially pre-dialysis measurements. Further studies should verify the external validity of these results.
期刊介绍:
Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.