Evaluation of hemodialysis adequacy using online Kt/V and single-pool variable-volume urea Kt/V

Abstract

SPVV urea Kt/V indicates a more adequate HD session than online Kt/V. This difference has to be considered when applying Kt/V to clinical practice.

Online Conductivity Monitoring of Dialysis Adequacy Versus Kt/V Derived from Urea Reduction Ratio: A Prospective Study from a Saudi Center

“…[10] In our study, a correlation coefficient between Kt/V obtained online and calculated as SPVV Kt/V with urea measurement in blood probes was about 0.48. This is in agreement with the correlation coefficient (r 2 = 0.5) obtained by Grzegorzewska et al [11] These researchers studied 40 patients, and the total number of sessions involved in his study were 80 for each method, whereas we included a smaller number of patients but recorded 408 sessions using Kt/V ID method and 136 sessions using urea reduction method. The results of McIntyre et al [10] indicate that the significantly greater correlation coefficient between values of SPVV urea Kt/V and online Kt/V can be obtained when blood sample for urea determination is drawn 30 minutes after the end of the HD session (R2 = 0.92, p < 0.0001).…”

“…[8,9] However, other studies reveal that OCM underestimate dialysis efficacy when compared with calculated Kt/V. [10,11] The aim of our study was to test the validity of ionic dialysance in determining Kt/V in comparison with the gold standard direct quantification method using the single-pool variable volume urea kinetic model (SPVV-UKM) in a series of Saudi hemodialysis patients.…”

Modulation of the immune response to HBV vaccination by hemodialysis membranes

“…Recent studies associated the inadequate immune response to vaccination seen in HD patients with male gender, advanced age, malnourishment and low body weight, blood transfusions, existence of anti-HCV antibodies and some haplotypes of the major histocompatibility complex inhibiting the effective [9,10] presentation of HBV antigen to T-lymphocytes [1,5,16]. The effects of HD membranes on the clearance of uremic toxins and inhibition of inflammatory activation may influence the antibody response to HBV vaccination in HD patients.…”

“…All patients received additive medication, such as antihypertensive agents, active vitamin D, essential aminoacid supplements, oral phosphorus binding agents, iron or erythropoietin was given according to their laboratory and clinical follow up. Patients with serum albumin levels \3.5 mg/dl and hemoglobin\9 g/dl; and who had malignancy except skin cancer, who required blood transfusion during vaccination schedule, needed additional HD session because of volume overload, and whose Kt/V \ 1.2 [9,10] and URR (urea reduction rate) \65 were not included to the study. One hundred and fifty-six patients with negative Hepatitis B and C serologic markers; not having any inadequacy of dialysis and malnutrition existence, and those which were found to be appropriate considering the excluding criteria, were included in the research.…”

Home dialysis as a first option: a new paradigm

“…Over a week, daily hemodialysis regimens achieve lower, time-average concentrations of many uremic solutes, e.g., urea, creatinine, hydrogen ion, potassium, and phosphorus, and, perhaps just as important, produce smaller oscillations in their blood levels, thus reducing the dialysis ''unphysiology'' as first described by Kjellstrand [67,68].…”