Influence of Kt/V and protein catabolic rate on hemodialysis morbidity. A long-term study

Urea clearance over time, divided by volume of total body water (Kt/V) and protein catabolic rate (PCR), were calculated monthly in 88 long-term hemodialysis patients. Patients were divided into four groups: Group A (n = 40), Kt/V > 1.0 and PCR > 1.0 g/kg/day; Group B (n = 7), Kt/V > 1.0 and PCR < 1.0; Group C (n = 24), Kt/V < 1.0 and PCR > 1.0; and Group D (n = 17), Kt/V < 1.0 and PCR < 1.0. Various clinical, biochemical, and morbidity factors were compared. Group A had significantly less morbidity than did the other groups (p < 0.05). Blood urea nitrogen, serum creatinine, serum albumin, and phosphorus were lower in Group B than in the other groups (p < 0.05). These data suggest that determination of Kt/V and PCR is important for predicting dialysis morbidity and that they should be monitored together for adequacy of therapy and dialysis quality assurance.