A comparison between urea reduction ratio and urea kinetic model in assessing hemodialysis adequacy in end stage renal disease

Abstract

Introduction: In recent years the burden of chronic kidney disease has increased worldwide. End Stage Renal Disease (ESRD) needs Hemodialysis as a common renal replacement therapy to reduce its morbidity and mortality. Hemodialysis adequacy must be maintained for effective treatment and is measured either by Urea Kinetic Model (Kt/V), Urea Reduction Ratio (URR), natural log Kt/V or Daugirdas 2nd generation formula. Though Kt/V is accurate, URR is commonly used in clinical practice because of its simplicity and clear concept. Objective: To estimate and compare URR with single pool Kt/V in assessing hemodialysis adequacy. Materials and Methods: An experimental prospective study consisting of 100 ESRD patients of either sex between 18-70 years, who were on hemodialysis maintenance. Blood urea was estimated by GLDH- urease method and serum creatinine by Jaffe’s method. Values were substituted in URR and Kt/V formula. Results and Conclusion: There was a significant difference in serum Urea levels after dialysis treatment (P< 0>positive correlation with Kt/V. Since the URR and Kt/V are closely related, their predictive power in terms of patient outcome is similar. However, use of Kt/V and urea modelling allows for comparing expected with predicted dialysis dose that can be used to analyse dialysis treatment and dialyzer clearance. Keywords: Urea reduction ratio, Kt/V, ESRD, Hemodialysis adequacy, Renal Dialysis, Urea