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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
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Update on Pediatric Hemodialysis Adequacy.
Bahia H Moustafa1, Mohamad Khaled ElHatw2, Ihab S Shaheen3
1Department of Pediatric Nephrology, Dialysis/Transplantation Unit, Faculty of Medicine, Cairo University Children Hospital, Cairo University, Cairo, Egypt.
Summary
Achieving high Kt/Vurea with dialyzers does not guarantee improved survival. Optimal dialysis adequacy requires considering equilibrated double-pool Kt/Vurea, UF-dry weight, and patient clinical data for better outcomes.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Dialysis Adequacy
Background:
- High Kt/Vurea targets using high reflux dialyzers often fail to improve patient survival.
- Current dialysis adequacy assessment may not fully capture patient well-being.
Purpose of the Study:
- To recommend improved parameters for assessing dialysis adequacy beyond simple Kt/Vurea.
- To identify clinical markers that contribute to better patient survival and quality of life.
Main Methods:
- Systematic electronic search of literature, guidelines, and reviews.
- Analysis of parameters including equilibrated double-pool Kt/Vurea, UF-dry weight, and protein catabolic rate.
- Evaluation of clinical data such as blood pressure, cardiac function, anemia, and nutrition.
Main Results:
- Equilibrated double-pool, weekly Kt/Vurea is recommended over per-session values.
- UF-dry weight and protein catabolic rate are crucial for accurate assessment.
- Clinical parameters like blood pressure control, cardiac health, and nutrition significantly impact outcomes.
Conclusions:
- A comprehensive approach to dialysis adequacy, integrating urea kinetic modeling with clinical data, improves patient outcomes.
- Frequent, shorter, or slower, longer dialysis sessions enhance solute clearance and patient quality of life.
- Optimized dialysis strategies can offset costs through reduced medication and hospitalization expenses.
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