Abstract
Introduction: Adequate delivered dose of solute removal (as assessed by urea reduction and calculation of Kt/V) is an important determinant of clinical outcome in chronic haemodialysis (HD) patients. This requires both prescription of an adequate dose of HD and regular assessment that the delivered treatments are also adequate. On line conductivity monitoring Kt/V OCM online clearance measurement (OCM) (OCM) -using sodium flux as a surrogate for urea- allows the repeated non-invasive measurement of Kt/V on each HD treatment. Methods: We prospectively studied 131 (63 males, 68 females) established chronic HD patients over 8 weeks period (1048 treatments). A pre and post dialyzer measurement of the conductivity is performed by two mutually independent temperature-compensated conductivity cells equipped with Fresenius 4008 S ® dialysis machines. Urea reduction was measured (once a week) by a single pool calculation using immediate post treatment sampling. No changes were made to any of the dialysis prescriptions over the study period. Values of calculated Kt/V (conventional method with Daugirdas’ formula) Kt/V Dau and simultaneously obtained online Kt/V OCM were compared. Results: There was a statistically significant difference between calculated Kt/V DAU and Kt/V OCM over the study period. The mean calculated Kt/V DAU was 1.459 ± 0.31, and mean OCM was 1.139 ± 0.14 (p = 0.000), yet there was moderate correlation between calculated Kt/V DAU and Kt/V OCM (r 2
Highlights
Adequate delivered dose of solute removal is an important determinant of clinical outcome in chronic haemodialysis (HD) patients
Quantification of the dialysis dose is an essential element in the management of chronic haemodialysis treatment because the adequacy of the dose has a profound effect on patient morbidity and mortality [1]
It is well recognized that an adequate delivery of haemodialysis (HD) dose is a crucial determinant in clinical outcome of chronic HD patients [2]
Summary
Adequate delivered dose of solute removal (as assessed by urea reduction and calculation of Kt/V) is an important determinant of clinical outcome in chronic haemodialysis (HD) patients. This requires both prescription of an adequate dose of HD and regular assessment that the delivered treatments are adequate. It is well recognized that an adequate delivery of haemodialysis (HD) dose (as measured by Kt/V derived from urea reduction) is a crucial determinant in clinical outcome of chronic HD patients [2] This requires both prescription of an adequate dose of HD and regular assessment that the delivered treatments are adequate [3]. There is often a difference, sometimes large, between the prescribed and delivered dose [4]
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