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Mouse Model of Acute to Chronic Kidney Disease Transition Induced by Renal Ischemia/Reperfusion Injury
Published on: February 10, 2026
Toward the optimal dose metric in continuous renal replacement therapy
Rolando Claure-Del Granado1, Etienne Macedo, Glenn M Chertow
1University of California San Diego, San Diego, California - USA.
The International Journal of Artificial Organs
|April 3, 2012
Summary
Measuring dialysis dose in acute kidney injury (AKI) is debated. This study found that kinetic modeling (KD) and equivalent kidney ratio (EKR) correlate well with actual solute removal, recommending KD for clinical practice.
Area of Science:
- Nephrology
- Critical Care Medicine
- Renal Replacement Therapy
Background:
- Optimal dialysis dose measurement in acute kidney injury (AKI) lacks consensus.
- Blood-based urea kinetic modeling and simplified blood urea nitrogen (BUN) methods are often used.
- Dialysate-side quantification is recommended for critically-ill AKI patients.
Purpose of the Study:
- To evaluate six blood-side and dialysate-side methods for quantifying dialysis dose in AKI.
- To compare different methods for assessing delivered dialysis dose.
Main Methods:
- Examined data from 52 critically-ill AKI patients undergoing continuous venovenous hemodiafiltration (CVVHDF).
- Calculated delivered dose using blood-side and dialysis-side kinetics.
- Assessed filter function by calculating BUN to dialysis fluid urea nitrogen (FUN) ratios.
Main Results:
- Both equivalent kidney ratio (EKR) and kinetic modeling (KD) showed good correlation with actual solute removal.
- EKR and KD values declined with decreased filter function, assessed by the FUN/BUN ratio.
- Effluent rate alone provides only an empirical estimate of dose in continuous renal replacement therapy (CRRT).
Conclusions:
- For clinical practice, measuring delivered dose as kinetic modeling (KD) is recommended.
- Equivalent kidney ratio (EKR) is a suitable method for dose comparisons over time and across modalities.
- Effluent rate is insufficient for accurate dose estimation in CRRT.
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