Calculation of Kt/V in haemodialysis: a comparison between the formulas

J Bras Nefrol. 2012 Mar;34(1):22-6.
[Article in English, Portuguese]

Abstract

Introduction: The quality of delivered dialysis can be measured by the Kt/V ratio, which can be calculated in various ways.

Objective: To compare the Kt/V ratio obtained with the formulas of Lowrie (L) and Daugirdas (D) with the results measured by an Online Clearance Monitor (OCM).

Method: Observational, cross-sectional study of 59 patients on hemodialysis (HD). Data were collected in the same dialysis session (predialysis and postdialysis urea) and Kt/V was calculated by the OCM of the Fresenius 4008S machine (Fresenius Medical Care AG, Bad Homburg, Germany).

Results: A total of 95 sessions were assessed, with a predominance of males 56% (33), and a sample mean age of 57 + 14 years. Hypertension (42%; n = 25), diabetes (12%; n = 7) and glomerulonephritides (8%; n = 5) were the most frequent causes of chronic kidney disease (CKD). Mean Kt/V values obtained with the L and D formulas and the OCM were 1.31, 1.41 and 1.32, respectively. Comparison between the L and D formulas showed a statistically significant difference (p = 0.008), with a Pearson's correlation of 0.950. The difference between the D formula and the OCM was also significant (p = 0.011 and r = 0.346), probably due to convective loss, estimated by the D formula but not by the OCM and L formula. The difference between the L formula and the OCM was not significant (p = 0.999 and r = 0.577).

Conclusion: These data suggest that the OCM can be used as a guide to the real-time adjustment of the dialysis dose.

Publication types

  • Comparative Study

MeSH terms

  • Cross-Sectional Studies
  • Drug Dosage Calculations*
  • Female
  • Hemodialysis Solutions / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis / methods*

Substances

  • Hemodialysis Solutions