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For a US perspective, see the KDOQI clinical practice guidelines [10] and for a United Kingdom perspective see: U.K. Renal Association clinical practice guidelines [11] According to the US guidelines, for thrice a week dialysis a Kt/V (without rebound) should be 1.2 at a minimum with a target value of 1.4 (15% above the minimum values). However ...
Kt/V and standardized Kt/V are not the same. Kt/V is a ratio of the pre- and post-dialysis urea concentrations. Standardized Kt/V is an equivalent clearance defined by the initial urea concentration (compare equation 8 and equation 10). Kt/V is defined as (see article on Kt/V for derivation):
A more accurate relationship between URR and Kt/V can be derived by single-pool, variable volume urea kinetic modeling. A simplified estimating equation also can be used. [2] This gives results that are quite similar to formal urea modeling as long as dialysis treatments of 2–6 hours in duration are given, and Kt/V is between 0.7 and 2.0.
The heavy green line shows the relation when UF/W - 0.03. So in practice, because of urea generation and UF/W, a 63% URR (0.63) results in a Kt/V of about 1.15 instead of only 1.0 (see graph). KDOQI hemodialysis adequacy standards are written in terms of either Kt/V or URR, with Kt/V being the preferred choices. But a patient may meet one ...
An stdKt/V value of 2.0 is considered to be a minimum amount for patients with no residual renal function, and corresponds to a spKt/V of 1.2 with a 3x/week dialysis schedule. The equations are very sensitive to session length (t) as well.
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure .
Hemodialysis product (HDP) - is a number used to quantify hemodialysis and peritoneal dialysis treatment adequacy. It was proposed by Scribner and Oreopoulous because of their perceived inadequacy of the Kt/V measure of dialysis adequacy. The HDP is defined by the following empirical formula: HDP = t * f 2. Where: HDP - hemodialysis product
Renal replacement therapy includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machines. Renal replacement therapy also includes kidney transplantation , which is the ultimate form of replacement in that the old kidney is replaced by a donor ...
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