A comparison of laboratory values in pediatric hemodialysis patients: does day of the week matter?

Nephrol Dial Transplant. 2012 Feb;27(2):816-9. doi: 10.1093/ndt/gfr385. Epub 2011 Jul 5.

Abstract

Background: The National Kidney Foundation Dialysis Outcomes Quality Initiative (NKF-K/DOQI) guidelines recommend the delivered dose of hemodialysis (HD) be measured no less than monthly by checking Kt/V (K is effective urea clearance, t is minute and V is urea distribution). To date, no studies have explored whether the day of the week for checking maintenance HD laboratory studies impacts dialysis dosing.

Methods: Data were collected at two HD facilities on 19 patients, ages ≤ 21 years receiving maintenance HD thrice weekly over a consecutive 6-month period. Data obtained from the Monday and Wednesday of each full third week of the month included dialysis vintage, ultrafiltration volume, serum electrolytes, hemoglobin and clearances.

Results: Kt/V and K+ were significantly different between Monday and Wednesday (P = 0.013 and P = 0.047, respectively).

Conclusion: Due to variability in values based on the day of laboratory evaluations, the dialysis provider must consider the impact of this on the quality of patient care when prescribing dialysis. Research on a larger scale needs to be conducted to allow for better decision-making capabilities in the chronic HD population.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Blood Chemical Analysis
  • Child
  • Cohort Studies
  • Creatinine / blood*
  • Dialysis Solutions / administration & dosage
  • Female
  • Follow-Up Studies
  • Hemodialysis Units, Hospital
  • Hemoglobins / analysis
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / therapy*
  • Kidney Function Tests
  • Kinetics
  • Male
  • Monitoring, Physiologic / methods
  • Potassium / blood
  • Prospective Studies
  • Quality Control
  • Renal Dialysis / adverse effects
  • Renal Dialysis / methods*
  • Risk Assessment
  • Treatment Outcome
  • Urea / metabolism*
  • Weight Gain

Substances

  • Dialysis Solutions
  • Hemoglobins
  • Urea
  • Creatinine
  • Potassium