Protein Loss Assessment in Patients on Continuous Ambulatory Peritoneal Dialysis with Optical Chromatographic Sensor

Continuous ambulatory peritoneal dialysis (CAPD) is a modality of renal replacement therapy in many situations presenting a better alternative to hemodialysis. Abnormally high peritoneal protein losses are considered as a serious side effect of CAPD and a possible predictor of dialysis peritonitis. Regular assessment of daily protein loss could potentially increase the safety and efficacy of the treatment. The aim of this work was development of algorithms and software for preprocessing and analysis of data obtained with the multiple-use optical chemical sensor based on fast protein liquid chromatography, which enables direct determination of total protein in effluent peritoneal dialysate using ultraviolet (UV) photometric detection with a deep UV LED. Algorithms for decomposition and approximation of chromatograms with a set of split Gaussian functions and estimation of protein concentration in dialysate were suggested and successfully applied. PD Monitor 1.0 software, which provides functionality for the control of the sensor operation, photometric data acquisition, preprocessing and analysis of dialysate chromatograms, calibration of the sensor, and daily peritoneal protein loss assessment was developed. To verify the algorithms and test the software dialysate samples from a group of 28 ESRD patients were analyzed with the sensor and by a standard biochemical assay: the average error of protein determination was about 10%. The developed system was proven to be a viable tool for monitoring CAPD patients, potentially as a point-of-care testing device.