Urea Monitor Based on Chemiluminescence and Electrolysis as a Marker for Dialysis Efficiency

We have developed a practical urea monitor based on a chemiluminescent (CL) reaction of urea and hypobromous acid produced by electrolysis of sodium bromide (NaBr) for measuring urea concentration in spent dialysate at set intervals. A reagent containing 4×10-2 M hypobromous acid is produced by electrolysis of an electrolyte containing 5.9 M NaBr and 0.2 M sodium hydroxide (NaOH). Chemiluminescence is emitted by injection of spent hemodialysis fluid (0.11 ml) into the reagent, and the CL-intensity is measured by a photomultiplier tube using the photon counting technique. The CL-intensity is proportional to the 0.9th power of the urea concentration between 7×10-4 and 2×10-2 M. The urea monitor can determine the urea concentration in spent dialysate samples collected from the waste line of a dialyzer, and the time for the intermittent measurements including the cleaning cycle of the reaction chamber is 3 min. The urea concentrations measured by the monitor are in close agreement with those measured by the conventional enzyme colorimetric method using urease for the spent dialysate collected during a hemodialysis treatment, and the correlation coefficient is 0.93.