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Calculating Standard Kt/V during Hemodialysis Based on Urea Mass Removed
John K Leypoldt1, Edward F Vonesh2
1, San Clemente, California, USAkenleypoldt@gmail.com.
Background/Aims:
We derived a novel equation for calculating weekly urea standard Kt/V (stdKt/V) during hemodialysis (HD) based on urea mass removed, comparable to the approach during peritoneal dialysis.
Methods:
Theoretical consideration of urea mass balance during HD led to the following equation for stdKt/V, namely, stdKt/V = N × (URR + UFV/V), where N is the number of treatments per week, URR is urea reduction ratio per treatment, UFV is ultrafiltration volume per treatment, and V is postdialysis urea distribution volume. URR required corrections for postdialysis rebound and intradialytic urea generation. We compared the accuracy of this approach with previous equations for stdKt/V by numerical simulations using a 2-compartment model of urea kinetics for thrice-weekly and more frequent HD prescriptions.
Results:
The proposed equation based on urea mass removed predicted values of stdKt/V that are equivalent to those calculated by previous equations for stdKt/V.
Conclusion:
This work provides a novel approach for calculating stdKt/V during HD and strengthens the theoretical understanding of stdKt/V.
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