Adequacy of Hemodialysis Assessed in CKD-ESRD Patients using Urea Reduction Rate and Single-Pool Kt/V.

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Introduction: Chronic kidney disease and end stage renal disease (ESRD) are major cause of morbidity and mortality. Renal replacement treatment in the form of hemodialysis, peritoneal dialysis or renal transplantation are the treatment of choice to ESRD. Hemodialysis has been the most preferred modality of treatment for sustaining the life of patients with end-stage kidney disease. Achieving adequacy in hemodialysis is a major challenge in treating these patients. Inadequate dialysis will result in high mortality. This study aimed to find out the mean value of the urea reduction ratio and Kt/V in fifty session of hemodialysis in 4 patients undergoing hemodialysis at a tertiary care centre. Methods: This was a prospective open labelled, controlled study design conducted over 3 month. Patients aged >18 years, undergoing maintenance hemodialysis were included in the study. Urea reduction rate and single-pool Kt/V were estimated. Statistical analysis: All data pertinent to the patients are obtained and the analysis of efficacy in terms of dialysis dose, urea reduction ratio (URR) and Kt/V were analysed using the Student’s paired T test, with a p <= 0.05 will be considered statistically significant. Results: Among fifty session of hemodialysis done for four hours through AV fistula the mean urea reduction ratio and standard deviation in the study was 62.49% and 9.7 respectively. Single pool Kt/V mean and standard deviation was 1.22 and 0.2 respectively Conclusions: URR was little lower and Kt/V was optimal as per standard guidelines. Hence estimating URR and Kt/V gives the evidence of adequacy of hemodialysis in addition to clinical assessment and thus helps in reducing morbidity and mortality in these patients. Keywords: chronic kidney disease (CKD), End stage renal disease (ESRD), hemodialysis, urea reduction ratio (URR) and Kt/V.