New empiric expressions to calculate single pool Kt/V and equilibriated Kt/V

Most formulae used for Kt/V computations are cumbersome and require variables that are not always available. Even the simplest models involve urea distribution volume or patient postdialysis weight. Calculating urea reduction ratio (URR) is easier and does not require additional variables, but it fails to account for residual renal function or for the removal of urea when urea levels do not change, e.g., during ultrafiltration. The goal of this study was to derive new expressions to calculate Kt/V based on URR using bivariate and multivariate linear and nonlinear models, with the URR adjusted for ultrafiltration volume and time on dialysis. Models were derived from a database of 598 dialysis records with a mean spKt/V of 1.6 (range 0.74-2.8). Models were validated on the same dataset that they were derived from and a separate dataset consisting of 17,190 dialysis records. The validation was made by comparing the empirically derived models with the Gotch and Daugirdas formulae. Among our empirically derived expressions, the closest approximation of the "gold standard," Kt/V, is the multivariate linear model of URR adjusted for ultrafiltration volume. When information about ultrafiltration is not available, the bivariate exponential formula can be successfully used to estimate Kt/V.