The Evaluvation of Dialysis Adequacy by KT/V in Hemodialysis Patients

Although there is no universally accepted target value for the KT/V in hemodialysis (HD) patients, the K/ DOQI guidelines are recommended that adult HD patients receive a minimum dialysis dose by KT/V of 1.2 or greater. In the study we aim to determine the adequacy of dialysis in our HD center in shahid Beheshti Hospital of Abadan city, Iran. In a cross – sectional study, we prospectively evaluated the valve of KT/V in our HD patients that were on dialysis more than 6 months. HD was performed for 3 to 4 hours, using synthetic dialyzer membranes, and the bicarbonate- based dialysate. Blood flow rate, dialysate flow rate and ultrafiltration rate were 250 to 300 cc / min, 500cc/min and zero or 1 to 3 liters, respectively.Blood sampling for blood urea nitrogen (BUN) was done immediately before and after the dialysis session. For postdialysis BUN, our practice was to slow the blood pump to 100 ml/ min and then obtain the blood sample 15 seconds later. We used following equation to estimate the KT/V from the percent reduction in urea (PRU). KT/V = (0.026 ×PRU) – 0.460 Fifty –four HD patients (28 females and 26 males) with mean age of 39 ± 14.2 years were enrolled in the study. The most common cause of end stage renal disease was hypertension followed by, unknown, DM, Glomerulonephritis, urinary tract abstraction and poly cystic kidney disease. KT/V was less than 1.2 in 87.03 patients (n=47). There was no significant difference in the valve of KT/V in men and women (P= 0.54) and in different hemoglobin concentration (p=0.58) The results of the study show that the most of our HD patients in our center have not received minimam dialysis dose and we should evaluate and correct its causes.