Naslov
Comparison of methods for hemodialysis dose calculation

Autori
Kovačić, Vedran ; Roguljić, Luka ; Jukić, Ivana ; Kovačić, Vinko

Izvornik
DIALYSIS & TRANSPLANTATION (0090-2934) 32 (2003), 4; 170-176

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Variable Volume ; KT/V ; Dialysis ; Reduction ; Mortality ; Sample ; Error ; Ratio

Sažetak
Introduction. The Kt/V value demonstrates the dose of hemodialysis (HD) and represents dialyzer clearance (K), distribution Volume of urea (V), and dialysis duration (t). However, because of several existing methods for calculating delivered dialysis dose, Kt/V values can, in fact, be different for the same set of pre-/postdialysis blood urea concentrations. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) recommends using the Daugirdas second-generation formula for calculating the delivered dialysis dose (Kt/V). We prospectively compared the "gold standards" of prescribed (urea kinetic model, UKM) and delivered (Daugirdas second-generation) Kt/V values with values obtained via the other existing formulae. Subjects and Methods. Data were processed on 208 dialysis treatments involving a group of 25 chronic HD patients. Outcome measures consisted of the single-dialysis delivered Kt/V calculated according to the Daugirdas second-generation, Lowrie, Keshaviah, Barth, Jindal, Basile, and Kerr formulae, as well as the prescribed Kt/V calculated according to UKM. For all treatments, the delivered Kt/V values were also calculated as equilibrated values according to the Daugirdas correction formula. Results. Most of the UKM Kt/V values were statistically different from the calculated delivered Kt/V values (p < 0.05) ; the exceptions were Kt/V values calculated according to the Daugirdas (p = 0.311), Barth (p = 0.124), and Jindal formulae (p = 0.84). Additionally, the Daugirdas Kt/V values and Daugirdas Kt/V equilibrated values were statistically different from all other calculated Kt/V values (p < 0.05). We found the least difference (i.e., the least mean of the absolute values of the differences) to be between the Barth Kt/V values and the Daugirdas Kt/V values (both single-pool and equilibrated). Discussion. We demonstrated significant differences between Kt/V Daugirdas (single-pool and equilibrated) and other delivered and prescribed Kt/V values. Despite the fact that no one formula can replace the Daugirdas second- generation formula, we can advise using Barth's formula as a nonlogarithmic counterpart to the Daugirdas formula. Barth's formula is simple and can be obtained using a simple pocket calculator in routine clinical practice. Every calculated Kt/V value should have bookmarks with regard to how the formula was calculated, including the postdialysis blood sampling method.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA