I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Des on July 27, 2010, 06:36:34 AM
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What is KT/v ?(hope Iam asking this correctly)
I know it is a test to see how good your dialysis is, but what should it actually be?
What is yours?
The new HDF machines gives the KTV reading after each treatment and I want to know if mine is ok.
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KT/V minimum is 1.2 but 1.6 to 1.8 is preferred.
The key is more dialysis is better, because KT/V is only based on UREA, and there are some solutes that are time-dependent in their removal.
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My typical KT/V is between 1.38 and 1.42. For a while we tried a new dialyser (can't recall the name/number but I will ask) and it was touted as 40% more efficient than the old ones. My projected KT/V on that was a super 1.59 but I always crashed on it. One time, I crashed within the first 1/2 hour of my run which NEVER happened before. After playing around with parameters for a few weeks (always resulting in a crash) we decided to switch back to the former dialyser.
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Mine is at a 2.0 which is good.
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Mine is 1.6 to 1.8 on PD with a gigantic hernia. They want it to be 2.0 or greater but I feel ok so they let me gimp along on a lower number.
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Kt/V is measured in the machine by measuring sodium (as a marker for urea I learned last week) and it's basically measuring your clearance. Our unit uses the URR (Urea Reduction Ratio) to achieve basically the same thing - but they do that using actual lab measurements of the urea before D starts, and when it finishes, and working out the difference, such that mine was 75% last time, so 3/4 of the toxins(based on urea) are being cleared out of my system by dialysis. Kt/V works on a similar principle of how much urea is in your blood fluid at the start and then at the end - clearly there should be less. So your Kt/V will be low at the start of D and stabalise out at the end. 1.2 is the minimum of "adequate" dialysis, 1.4 is preferred (this is for hemo patients, PD is different I know) and above 1.5/1.6 is considered to be good. I think mine was measured at 1.47 last run, but then they discovered that some idiot had entered in my details into the machine as a female instead of male :rofl; :rofl; :rofl; :rofl; :rofl; so the calciulations wound up being wrong.
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My PD clinic wants Kt/V to be 2.2 or higher. HD Kt/V should be lower than PD's.
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There is a mathematical relationship between Kt/V and URR.
Kt/V = - ln (1 - URR)
where ln denotes the natural logarithm.
Example: RichardMEL said that his URR for his last treatment was 0.75
Using the above relationship, his Kt/V would equal -ln(1 - 0.75)
which equals 1.4
which ain't bad
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Here's more information on Kt/V than you will ever want to know:
http://en.wikipedia.org/wiki/Kt/V
8)
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THIS IS BRILLIANT. I will check mine tonight.
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Mine averages at 1.29 - the ideal is 1.4 (according to my neph)
The only way I can increase this is to increase pump speed - not happening- my pulse rate goes up
To get bigger needles - nog doing that either - fistula is still too young.
so..... I will have to be happy with the 1.29 for now - at least the doc is happy.
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Mine averages at 1.29 - the ideal is 1.4 (according to my neph)
The only way I can increase this is to increase pump speed - not happening- my pulse rate goes up
To get bigger needles - nog doing that either - fistula is still too young.
so..... I will have to be happy with the 1.29 for now - at least the doc is happy.
It took me 6 months of dialysis to get up to a 14 g. needle w/ a 400 flow rate. My Kt/V was at last check 1.92.
Give your Fistula some time, it will develop and then they can start using the larger needles. It took me almost 1 year from when I had my Fistula installed.
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Mine averages at 1.29 - the ideal is 1.4 (according to my neph)
The only way I can increase this is to increase pump speed - not happening- my pulse rate goes up
To get bigger needles - nog doing that either - fistula is still too young.
so..... I will have to be happy with the 1.29 for now - at least the doc is happy.
Increasing your treatment time will also raise your Kt/V.
1.29 is barely minimum.
8)
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My latest Kt/V have been around 1.32, which I understand is low. However my URR is 75% which is very acceptable. I'm doing 5 hours HD @ pump speed 300 (if I go higher I tend to have problems). It's times like this I wonder which number to believe. My URR (clearance) is good, yet the kt/V is not so wonderful. I feel OK. I don't care enough to make a big deal about it, and I sure as hell don't want MORE time on the machine just for a higher number. I figure if I'm clearing over 70% of my toxins in a treatment that's pretty good. Our unit tend to go on the URR as more accurate than Kt/V anyway.
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The problem with both URR and Kt/V is that they are based on Urea removal.
Urea is a small molecule and is easily removed by dialysis.
It's the middle molecules that are time dependent and may cause more of the long-term side effects of hemodialysis, so five hours is a very good duration for treatment.
While phosphorus is a small molecule, it is also time dependent.
Maybe they should use it in measuring Kt/V and PRR (instead of URR).
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