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Session: Poster Session 1 (Even numbers)
Session starts: Thursday 26 January, 16:00
Presentation starts: 16:00

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Sophie Adelaars (Catharina Hospital Eindhoven)
Stijn Konings (Catharina Hospital Eindhoven)
Lieke Cox (Philips Research)
Massimo Mischi (Eindhoven University of Technology )
Arthur Bouwman (Catharina Hospital Eindhoven)
Daan van de Kerkhof (Catharina Hospital Eindhoven)

Abstract:
In a large proportion of patients with end-stage renal failure, haemodialysis (HD) adequacy is performed multiple times a week, which results in high disease burden. To determine clearance adequacy in HD, the urea concentration is analysed in blood samples taken before and after HD cycles. To enable HD to be performed in a home situation, which is a promising future development to improve patient quality of life, there is a clinical need to perform continuous and non-invasive monitoring of urea kinetics without taking blood samples. To this end, saliva and sweat are potential alternative matrices to monitor HD adequacy. The aim of this study was to determine whether the urea concentration in sweat and saliva is associated with the plasma concentration in HD patients. Sweat and salivary urea concentrations were analysed at the start and at the end of one HD cycle and compared to the corresponding plasma concentrations. Here, we report interim results (N = 31) in a study that is aimed to include 40 HD patients in total, which started October 2021. Concentrations in sweat were significantly higher than plasma concentrations at the start and end of HD (both p<0.001). Salivary concentrations were also significantly higher at the start (p<0.01), but not at the end of HD. In plasma, the urea concentration decreased from 21.50 (17.00 – 25.25) mmol/L to 5.75 (4.15 – 7.25) mmol/L (median (IQR)) in the studied HD cycle. A decrease was also observed in sweat, from 27.30 (21.70 – 32.78) mmol/L to 11.01 (7.87 – 14.42) mmol/L, and in saliva, from 24.60 (21.05 – 29.55) mmol/L to 5.63 (4.02 – 7.11) mmol/L. Urea concentrations in plasma showed a significant correlation (p<0.001) with sweat urea concentrations (Spearman’s correlation r 0.932 (0.873 – 0.964)) and with salivary urea concentrations (r 0.929 (0.885 – 0.957)). Although the findings of this interim analysis are preliminary, the results illustrate a proof of principle of urea measurements in sweat and saliva to monitor HD in a non-invasive continuous manner. These findings indicate that studies aimed at developing data algorithms and bio-sensing methods using sweat or saliva for application in a clinical setting deserve further attention.