Clearance for middle molecules and fluids are also being looked into as independent markers of dialysis adequacy.
The primary goal of this work was the untargeted identification and quantification of volatile organic compounds characterizing uremic breath and blood with a particular focus on species responding to the dialysis treatment, the latter being potential markers of dialysis efficiency.
Several studies demonstrated the potential of FGF-23 as a marker of mortality in dialysis patients [ 29], initiation of chronic dialysis [ 30], CKD progression [ 31, 32], cardiovascular disease [ 30], cardiovascular mortality [ 32] or all-cause mortality [ 30, 32].
BUN, a waste product of protein catabolism, has been extensively studied in dialysis patients and is an important target for removal by (hemo) dialysis, as well as a marker for the effectiveness of dialysis.
These nondifferential alterations do not discredit A1C as a reliable long-term marker of glycemic control in dialysis patients as long as appropriate adjustments to interpret A1C values are made.
However, a recent literature review noted increased reporting of vertebral brown tumours in patients with ESRD over the last few decades for which this may simply reflect increased reporting or be a marker of increased survival in dialysis populations resulting in a true increase in the incidence of cases [ 8].
As for the indirectness of outcome, GFR is a candidate surrogate marker to predict kidney failure or initiation of dialysis.
Monitoring of breath ethane in HD patients evidenced a rapid rise of this marker during the first minutes after initiation of dialysis, which has been attributed to treatment-induced oxidative stress [ 15- 17].
Further analysis showed that dialysis vintage was correlated with PTH at cinacalcet start (data not shown) and other reports indicate that the prevalence of parathyroidectomy (as a marker of severe SHPT) increases with dialysis vintage [ 31, 32].
We measured serum lactoferrin as a marker of polymorphonuclear neutrophil activation during dialysis sessions by using a home-made ELISA with rabbit anti-human lactoferrin and purified human lactoferrin purchased respectively from Biodesign International (Saco, USA) and Sigma-Aldrich Saint Quentin Fallavierr, France).
