Quantification of Hemodialysis Dose: What Kt/V to Choose?

Aatif, Taoufiq; Hassani, Kawtar; Alayoud, Ahmed; Zajjari, Yassir; Maoujoud, Omar; Benyahia, Mohamed; Oualim, Z.

doi:10.5301/ijao.5000236

Cited by 12 publications

(13 citation statements)

References 41 publications

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“…This method does not require blood sampling and can be used with each dialysis treatment. However, more recent studies has shown that Kt/V OCM with V determined by Watson formula, leads to systematic underestimation of Kt/V by 22%–24% when comparing to Kt/V derived from urea reduction using the Daugirdas second generation equation …”

Section: Clinical Standard and Targetsmentioning

confidence: 96%

Clinical practice guidelines for the provision of renal service in Hong Kong: Haemodialysis

Cheng

Tang²,

Tong³

2019

Nephrology

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Section: Clinical Standard and Targetsmentioning

confidence: 96%

Clinical practice guidelines for the provision of renal service in Hong Kong: Haemodialysis

Cheng

Tang²,

Tong³

2019

Nephrology

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“…It is now clearly recognized that anthropometric formulae overestimate total body water (V) in hemodialyzed patients by about 20% 22‐24 . This explains why the K ID t/V value calculated from ionic dialysance and Watson's formula underestimates sp Kt/V by about 20% and is close to e Kt/V 25 …”

Section: Ionic Dialysance Monitoringmentioning

confidence: 99%

Routine online assessment of dialysis dose: Ionic dialysance or UV‐absorbance monitoring?

Petitclerc

Ridel

2021

Seminars in Dialysis

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For three‐weekly hemodialysis, a single‐pool Kt/V target of at least 1.4 together with a minimal dialysis dose Kt at 45 L for men and 40 L for women per each session is currently recommended. Fully automatic online calculation of Kt and Kt/V from conductivity or UV‐absorbance measurements in the dialysate is standardly implemented on some hemodialysis monitors and makes it possible to estimate the dialysis dose without the need for blood or dialysate samples. Monitoring the UV‐absorbance of the spent dialysate is the most direct method for estimating Kt/V as it does not require an estimate of V. Calculation of ionic dialysance from conductivity measurements is the most direct method for estimating Kt and BSA‐scaled dialysis dose. Both ionic dialysance monitoring and UV‐absorbance monitoring may help detect a change in urea clearance occurring during the session, but this change must be interpreted differently depending on the monitoring being considered. An abrupt decrease in urea clearance results in a decrease in ionic dialysance but, paradoxically, a sudden increase in estimated urea clearance provided by dialysate UV‐absorbance monitoring. Healthcare teams who monitor both ionic dialysance and UV‐absorbance in their hemodialysis units must be clearly informed of this difficulty.

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“…The most validated and universally used parameter to evaluate the dialysis dose is the assessment of the urea removal rate by means of the Kt/V. In this parameter, "K" is the effective urea clearance (commonly accepted as the solute marker of uremic toxicity), «t» is the time of duration of the dialysis session and «V» is the urea volume of distribution [5]. The Kt/V is a crucial determinant in the clinical outcome of the patients on chronic HD, considering as an adequate Kt/V value ≥ 1.2 per session [6,7].…”

Section: Introductionmentioning

confidence: 99%

Optimizing dialysis dose in the context of frailty: an exploratory study

et al. 2021

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Introduction Frailty is a multicausal syndrome characterized by a decrease in strength, resistance and physiological function, which makes the individual vulnerable and dependent, and increases his/her mortality. This syndrome is more prevalent among older individuals, and chronic kidney disease patients, particularly those on dialysis. Dialysis dose is currently standardized for hemodialysis (HD) patients regardless of their age and functional status. However, it has been postulated that the dialysis dose required in older patients, especially frail ones, should be lower, since it could increase their degree of frailty. Then, the purpose of this study was to evaluate if there would be a correlation between the dose of Kt/V and the degree of frailty in a population of adult patients on HD. Materials and methods A cross-sectional study with 82 patients on HD in Barranquilla (Colombia) and Lobos (Argentina) was conducted. Socio-demographic and laboratory data, as well as dialysis doses (Kt/V) were recorded and scales of fragility, physical activity, gait and grip strength were applied. Then these data were correlated by a Spearman's correlation and a logistic regression. Results CFS, social isolation, physical activity, gait speed, and prehensile strength tests were outside the reference ranges in the studied group. No significant correlation was found between dialysis dose and all the above mentioned functional tests. However, a significant and inverse correlation between physical activity and CFS was documented (score − 1.41 (CI − 2.1 to − 0.7). Conclusion No significant correlation was documented between Kt/V value and different parameters of the frailty status, but this status correlated significantly and inversely with physical activity in this group. Frailty status in hemodialysis patients was significantly higher in older individuals, although young individuals were not exempt from it.

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Quantification of Hemodialysis Dose: What Kt/V to Choose?

Cited by 12 publications

References 41 publications

Clinical practice guidelines for the provision of renal service in Hong Kong: Haemodialysis

Clinical practice guidelines for the provision of renal service in Hong Kong: Haemodialysis

Routine online assessment of dialysis dose: Ionic dialysance or UV‐absorbance monitoring?

Optimizing dialysis dose in the context of frailty: an exploratory study

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