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[Proposal of new formulas for three-point urea kinetics, compared with traditional kinetics and direct dialysis
G M Bosticardo1, U Avalle, A Serra
1Servizio di Nefrologia e Dialisi, Ospedale, Ivrea, Torino.
Abstract:
Classical urea kinetic model (UKM) has been followed by several proposals to determine dialysis adequacy either by direct quantification (DDQ), either by simplified two-points formulas (pre- and post-dialysis BUN), or by mUKM, a modified three-point algorithm (pre-post and pre-next dialysis), where urea distribution volume is input to obtain clearance and urea generation rate. Our new formulas (mUKM2) are derived from urea mass balance, and avoid iterative calculation: their results are similar to those obtained by UKM and mUKM when the standard post-dialysis BUN value is employed. On the contrary, when the equilibrated net-rebound value (Cpwnr) is employed their results are very close to the reference DDQ model: however the new approach is simpler and more practical, to measure dialysis dose taking account of the urea rebound phenomenon.