Mathematical Modeling of Dialysis
Sirshendu De, Anirban Roy in Hemodialysis Membranes, 2017
Another parameter used to understand dialysis adequacy is urea reduction ratio (URR). It is defined asCt/C0 is known as urea reduction fraction, denoted by R. Combining Equations 7.28 and 7.29, we haveIt is recommended that for dialysis adequacy, URR ~ 6529; hence, Kt/V ~ 1.2. This explains the reason behind maintaining Kt/V at 1.2, as discussed in Chapter 2.
Nephrology in China: A Specialty Preparing for the 21st Century Challenge
Meguid El Nahas in Kidney Diseases in the Developing World and Ethnic Minorities, 2005
The average frequency of dialysis is 2.3 times per week. According to the data from Shanghai, the mean URR value was 0.63 (1285 cases) and the mean Kt/V was 1.34 (1227 cases) in HD patients and the average value of Kt/V was 1.7 for CAPD. The Kt/V was less than 1.2 and more than 1.6, both accounted for 21.8% in 2626 HD patients. Inadequate hemodialysis was found in a certain part of cases (1).
Risk factors associated with bloodstream infections in end-stage renal disease patients: a population-based study
Published in Infectious Diseases, 2018
Gabrielle Dagasso, Joslyn Conley, Elizabeth Parfitt, Kelsey Pasquill, Lisa Steele, Kevin Laupland
Detailed demographic (age, gender), clinical (co-morbid conditions, infection focus) organisms, management (treatments, admission to hospital and transfers, ICU admission) and outcome (in-hospital and all-cause 30- and 90-day case fatality) data were obtained for both the case patients and the control patients. The Charlson Comorbidity Index was used to determine both the case and the controls scores; however, it was modified as ESRD was not considered a comorbidity [14]. The Charlson Comorbidity Index for each patient was calculated at the time of infection for cases and the same date for paired controls. KT/V measurements were calculated for each patient at the same time as the Charlson scores were. KT/V is a unit less measurement of dialysis adequacy, K stands for dialysis clearance (mL/min), T stands for time, and V stands for the volume of water in a patient’s body.
Kt/V reach rate is associated with clinical outcome in incident peritoneal dialysis patients
Published in Renal Failure, 2022
Shuang Liu, Lijie Zhang, Shuang Ma, Jing Xiao, Dong Liu, Rui Ding, Zhengyan Li, Zhanzheng Zhao
There are several possible reasons for the relationship between Kt/V and prognosis. First, Kt/V is an important quantitative index to evaluate small solute clearance, and is known as one of the major determinants of dialysis adequacy. Second, Kt/V has a protective effect on RRF preservation [16]. Patients with better RRF have a better prognosis [17]. Third, it has been reported that high Kt/V can reduce the incidence of peritonitis [8]. Peritonitis is a major cause of death and technique failure in PD patients. Fourth, Kt/V is inversely correlated with over-hydration [18], promoting the removal of fluid and sodium. Last but not least, there is a positive association between Kt/V and hemoglobin [16], which can improve the prognosis. Unfortunately, we did not see a difference in clinical outcome between the lower-rate group and the higher-rate group. A plausible explanation is that good clinical status weakens the effect of Kt/V on prognosis, since there was no difference in clinical indicators between the two groups except BMI, creatinine, and RRF (data not shown).
Association between neutrophil gelatinase-associated lipocalin (NGAL) and iron profile in chronic renal disease
Published in Archives of Physiology and Biochemistry, 2022
Ziba Aghsaeifard, Reza Alizadeh, Nazilla Bagheri
47 haemodialysis patients (mean age, 62.8 ± 9.4 years; 20 men and 27 women) and 15 control were enrolled in this observational laboratory study. The control group consisted of 15 healthy volunteers (mean age, 36.3+_7.4 years, 7 men, 8 women, with normal renal function; creatinine less than 1.5 mg/dl and without anaemia) were recruited mainly from medical staff and their fellows, who were age and sex-matched. The causes of renal failure among HD patients were diabetes mellitus in 23 patients, primary glomerulonephritis in 6, interstitial nephritis in 4, hypertension in 5, obstructive nephropathy in 2, and unknown in 7. The mean Kt/V was 1.57 ± 0.57. The patients underwent regular HD via an arteriovenous fistula or permanent catheter. Polysulfone low-flux dialysis membranes and a bicarbonate dialysis solution containing 1.25 mmol/L or 1.5 mmol/L of calcium were used. Haemodialysis sessions (4 h) was performed 3 times a week and for at least 1 year prior to the study. The KT/V according to the second-generation natural logarithmic formula, based on the single-pool urea kinetic model, was 1.21 ± 0.19. Patients with a history of blood transfusion in recent 2 months, bleeding, malignancies, cardiac problems, liver or thyroid diseases, infections and any changes in peripheral blood leukocytes or any kind of immunodeficiency/immunosuppression pathologies were excluded.
Related Knowledge Centers
- Body Water
- Diffusion
- Hemodialysis
- Molecular Diffusion
- Peritoneal Dialysis
- Protein
- Semipermeable Membrane
- Urea
- Urea Reduction Ratio
- Standardized Kt/V