KT/v??

[Des]

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.

[Zach]

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.

[RenalSurvivorDotCA]

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.

[sullidog]

Mine is at a 2.0 which is good.

[*kana*]

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.

[RichardMEL]

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  so the calciulations wound up being wrong.

[Jie]

My PD clinic wants Kt/V to be 2.2 or higher. HD Kt/V should be lower than PD's.

[RightSide]

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

[Zach]

Here's more information on Kt/V than you will ever want to know:
http://en.wikipedia.org/wiki/Kt/V

[Des]

THIS IS BRILLIANT. I will check mine tonight.

[Des]

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.

[Hazmat35]

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. 

[Zach]

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.

[RichardMEL]

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.

[Zach]

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).