Abstract
Background On-line urea clearance estimation, currently available on some dialysis monitors, makes it possible to calculate the dialysis dose Kt and thus allows to estimate Kt/ V for each session, providing an estimation of urea distribution volume ( V) at equilibrium assumed equal to total body water. Methods Three methods suitable for routinely estimating V, using the anthropometric Watson formula ( V Wat), the body composition monitor (BCM) device (Fresenius Medical Care) based on bio-impedance analysis ( V imp) and the indirect estimation ( V Daug) obtained from measurement of Kt/ (Kt/ V) sp ratio respectively are compared during 25 dialysis sessions in 15 patients to a direct estimation ( V DDQ) obtained by direct quantification of dialysis (DDQ) considered as the gold standard in hemodialysis patient.. Results V Watson overestimates V DDQ by about 20%. The values of V imp (29.1 ± 5.6 L) and V Daug (29.5 ± 4.6 L) are in agreement with V DDQ (29.9 ± 5.2 L). Correlation coefficient with V DDQ is better for V imp ( r = 0.94) than for V Daug ( r = 0.85). Conclusion Bio-impedancemetry using BCM and indirect method using the second generation Daugirdas equation are two methods of clinical interest for estimating V. Bio-impedancemetry does not require blood sample, but it needs to have a specific device at disposal.
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