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Some investigators have proposed dosing based on surface area (S) instead of V, but clinicians usually measure the URR and then calculate Kt/V. One can "adjust" the Kt/V, to calculate a "surface-area-normalized" or "SAN"-Kt/V as well as a "SAN"-standard Kt/V. This puts a wrapper around Kt/V and normalizes it to body surface area. [8]
Standardized Kt/V, also std Kt/V, is a way of measuring dialysis adequacy. It was developed by Frank Gotch and is used in the United States to measure dialysis. Despite the name, it is quite different from Kt/V. In theory, both peritoneal dialysis and hemodialysis can be quantified with std Kt/V.
Since the URR and Kt/V are so closely related, their predictive power in terms of patient outcome is similar. However, use of Kt/V and urea modeling in general allows for comparing expected with predicted dose of dialysis, which can be used to analyze dialysis treatments and dialyzer clearances and in troubleshooting and quality control ...
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.
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 standard and not the other, depending on the level of UF/W.
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.
The AIDA software is intended to serve as an educational support tool and can be used by anyone — person with diabetes, relative of a patient, health care professional (doctor, nurse, clinical diabetes educator, dietician, pharmacist, etc.), or student — even if they may have minimal knowledge of the pathophysiology of diabetes mellitus.
In nephrology, dialysis adequacy is the measurement of renal dialysis for the purpose of determining dialysis treatment regime and to better understand the pathophysiology of renal dialysis. [1] It is an area of considerable controversy in nephrology .
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