Evaluation of dialysis adequacy based on Kt/V and its related factors among patients undergoing hemodialysis in Guilan dialysis centers

 Adequate and effective dialysis can improve patients’ quality of life and reduce kidney failure complications and mortality in end-stage renal disease on hemodialysis.

 This study aimed to evaluate dialysis adequacy based on Kt/V and its related factors among patients undergoing hemodialysis.

 This cross-sectional, multi-center study was conducted during six months on hemodialysis patients referred to dialysis centers of the Guilan province in the north of Iran. Dialysis adequacy was evaluated using Kt/V (>1.2) criteria.

 The mean Kt/V was 1.24±0.36 with a median of 1.2. Adequacy of dialysis was desirable in 51.2% of the patients. There was a significant and inverse relationship between body mass index (BMI) and Kt/V (r=-0.139, P=0.013). The relationship between Kt/V criterion and pre-dialysis weight (r=-0.310, P=0.00) and post-dialysis weight (r=-0.314, P=0.00) were inverse. The Kt/V criterion was significantly associated with calcium (Ca) level and the patients with normal Ca level had a higher adequacy than those in the other levels of Ca [normal versus low level, mean difference (MD]: 0.19±0.06; normal versus high level, MD: 0.07±0.04, P<0.001). The Kt/V criterion was inversely related to blood pressure and temperature before and after dialysis (P<0.05).

 The present study showed a close correlation between blood pressure, Ca level and BMI with dialysis adequacy based on Kt/V criteria. The findings obtained here suggested treatment strategies based on correction of Ca levels, BMI and blood pressure prior to dialysis to increase the adequacy of dialysis.