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Online conductivity monitoring of dialysis adequacy versus Kt/V derived from urea reduction ratio: A prospective study from a Saudi center.

Al Saran K, Sabry A, Abdulghafour M, Yehia A - Int J Nephrol Renovasc Dis (2009)

Bottom Line: Values of calculated Kt/V and simultaneously obtained online Kt/V were compared.There was a statistically significant difference between calculated Kt/V and online Kt/V over the study period.Online conductivity monitoring results underestimates dialysis efficiency compared to calculated Kt/V readings.

View Article: PubMed Central - PubMed

Affiliation: Prince Salman Center for Kidney Disease, Riyadh, Kingdom of Saudi Arabia;

ABSTRACT

Introduction: Ad equate delivered dose of solute removal (as assessed by urea reduction and calculation of Kt/V) is an important determinant of clinical outcome in chronic hemodialysis (HD) patients. This requires both prescription of an adequate dose of HD and regular assessment that the delivered treatments are also adequate. Online conductivity monitoring using sodium flux as a surrogate for urea allows the repeated noninvasive measurement of Kt/V on each HD treatment.

Methods: We prospectively studied 17 (9 males, 8 females) established chronic HD patients over an eight-week period (408 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 and simultaneously obtained online Kt/V were compared.

Results: There was a statistically significant difference between calculated Kt/V and online Kt/V over the study period. The mean calculated Kt/V was 1.37 ± 0.09, and mean online Kt/V 1.02 ± 0.15 (P = 0.000), calculated Kt/V ≥ 1.2 was achieved in all our patients while online Kt/V ≥ 1.2 was achieved in only 17.64 %. Yet there was moderate correlation between calculated Kt/V and online Kt/V (r(2) = 0.48).

Conclusions: Online conductivity monitoring results underestimates dialysis efficiency compared to calculated Kt/V readings. This difference has to be considered when applying Kt/V to clinical practice.

No MeSH data available.


Comparison between OCM and Kt/V over the study period.Abbreviation: OCM, online conductivity monitoring.
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f2-ijnrd-2-027: Comparison between OCM and Kt/V over the study period.Abbreviation: OCM, online conductivity monitoring.

Mentions: This was performed between all obtained online Kt/V and Kt/V (measured by urea). Two values of online Kt/V were used for correlation: simultaneous Kt/V, taken at the same time when urea measurements were performed, and mean Kt/V representing the mean Kt/V value for both methods. There was considerable variation in both delivered Kt/VID and Kt/V (measured by urea) when compared individually every week as illustrated in Figure 2.


Online conductivity monitoring of dialysis adequacy versus Kt/V derived from urea reduction ratio: A prospective study from a Saudi center.

Al Saran K, Sabry A, Abdulghafour M, Yehia A - Int J Nephrol Renovasc Dis (2009)

Comparison between OCM and Kt/V over the study period.Abbreviation: OCM, online conductivity monitoring.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108763&req=5

f2-ijnrd-2-027: Comparison between OCM and Kt/V over the study period.Abbreviation: OCM, online conductivity monitoring.
Mentions: This was performed between all obtained online Kt/V and Kt/V (measured by urea). Two values of online Kt/V were used for correlation: simultaneous Kt/V, taken at the same time when urea measurements were performed, and mean Kt/V representing the mean Kt/V value for both methods. There was considerable variation in both delivered Kt/VID and Kt/V (measured by urea) when compared individually every week as illustrated in Figure 2.

Bottom Line: Values of calculated Kt/V and simultaneously obtained online Kt/V were compared.There was a statistically significant difference between calculated Kt/V and online Kt/V over the study period.Online conductivity monitoring results underestimates dialysis efficiency compared to calculated Kt/V readings.

View Article: PubMed Central - PubMed

Affiliation: Prince Salman Center for Kidney Disease, Riyadh, Kingdom of Saudi Arabia;

ABSTRACT

Introduction: Ad equate delivered dose of solute removal (as assessed by urea reduction and calculation of Kt/V) is an important determinant of clinical outcome in chronic hemodialysis (HD) patients. This requires both prescription of an adequate dose of HD and regular assessment that the delivered treatments are also adequate. Online conductivity monitoring using sodium flux as a surrogate for urea allows the repeated noninvasive measurement of Kt/V on each HD treatment.

Methods: We prospectively studied 17 (9 males, 8 females) established chronic HD patients over an eight-week period (408 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 and simultaneously obtained online Kt/V were compared.

Results: There was a statistically significant difference between calculated Kt/V and online Kt/V over the study period. The mean calculated Kt/V was 1.37 ± 0.09, and mean online Kt/V 1.02 ± 0.15 (P = 0.000), calculated Kt/V ≥ 1.2 was achieved in all our patients while online Kt/V ≥ 1.2 was achieved in only 17.64 %. Yet there was moderate correlation between calculated Kt/V and online Kt/V (r(2) = 0.48).

Conclusions: Online conductivity monitoring results underestimates dialysis efficiency compared to calculated Kt/V readings. This difference has to be considered when applying Kt/V to clinical practice.

No MeSH data available.