Comparative Study between Classic and Newer Methods for the Evaluation of Hemodialysis Adequacy

Abstract

Aim: The comparative study of hemodialysis (HD) adequacy of Kt/V measurement between classic method (Daugirdas formula) and urea sensor monitor (online).Patients and methods: 30 patients with end‐stage renal failure undergoing dialysis were studied. A comparative evaluation of HD adequacy during the same session was done with two different methods: (1) blood samples were drawn in the beginning and in the end of HD session for the measurement of blood urea nitrogen (BUN) and after measurement of HD adequacy by 3rd generation Daugirdas formula and (2) urea sensor monitor use for continuous HD adequacy measurement during HD session.Results: There was statistically significant correlation of Kt/V Daugirdas with Kt/V online (r = 0.8, p < 0.001). Also there was statistically significant correlation between solute removal index (SRI), Kt/V Daugirdas (r = 0.81, p < 0.001) and Kt/V online (r = 0.92, p < 0.001). From nutrition indices that were measured, the protein catabolic rate (PCR) had marginal negative correlation with the two compared adequacy indices, Kt/V Daugirdas (r = −0.24, p < 0.03), and Kt/V online (r = −0.17, p < 0.03) although the nPCR (normalized PCR) had marginal positive correlation (r = 0.35, p < 0.05) (r = 0.42, p < 0.05).Conclusions: The use of online urea sensor monitors contributes to the easy measurement of adequacy and nutrition indices and hence complicated mathematical formulas are not necessary. The results of these measurements are reliable and comparable with classic methods of HD adequacy evaluation.