Abstract: SA-PO0409
Exploring Urea Clearance Measurement in a Wearable Sorbent-Based Peritoneal Dialysis (PD) Device
Session Information
- Home Dialysis: Science and Cases, from Lab to Living Room
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Jain, Arsh, London Health Sciences Centre, London, Ontario, Canada
- Htay, Htay, Singapore General Hospital, Singapore, Singapore
- Brown, Edwina A., Imperial College London, London, England, United Kingdom
- Schreiber, Martin J., Cleveland Clinic, Cleveland, Ohio, United States
- Gow, Sheena, Vivance, Singapore, Singapore
- Lim, Jason Tze Chern, Vivance, Singapore, Singapore
- Singh, Sanjay, Vivance, Singapore, Singapore
- Gori, Mandar, Vivance Inc, Los Angeles, California, United States
- Foo, Marjorie Wai Yin, Singapore General Hospital, Singapore, Singapore
Background
In recent times, evaluating dialysis adequacy has shifted from a single solute target, i.e. Kt/Vurea, to a more holistic assessment of patients. However, some jurisdictions still mandate Kt/Vurea targets for reimbursement purposes.
Methods
Viva Kompact (VK) is a wearable, sorbent-based PD device. It regenerates 250mL of dialysate at a flow rate of 2L/hr over 56 cycles. The urea removal process in the sorbent during regeneration of dialysate makes it challenging to accurately assess solute removal, making standard PD Kt/Vurea formula of drained dialysate non-representative of the actual dialysis dose delivered. During the pre-pivotal study, VK clearance dynamics was explored – multiple outflow (leaving peritoneum) and inflow samples were taken at Cycle 4, 8, 40 and 54. These were done during full day training sessions and the first day of the 7-day Treatment period.
Results
12 subjects’ data were analysed; 10 male, dialysis vintage: 7-94 months, transport status: 1 High, 7 High A., 3 Low A., 1 Low and 1 anuric. Figure 1 shows urea levels throughout 7 hours of tidal therapy of 50 therapies, averaged across each subject; outflow urea during tidal therapy were lower than in final drain, supporting the notion that using final drain urea in the Kt/Vurea formula would not be representative of tidal clearance. During inflow, urea was mostly at undetected levels(<0.8mmol/L). As such, to cater for differences, it was proposed that tidal clearance be calculated separately from final drain clearance with a modified formula (Figure 2):
Conclusion
This study highlights the need of a modified Kt/Vurea formula for sorbent-based dialysis. While it is still used as a measure of PD efficacy, the quality of PD should be approached holistically, without relying only on small-solute clearances.
Figure 1
Figure 2
Funding
- Commercial Support – Vivance Pte Ltd