KT/V

[Ken Shelmerdine]

When I was doing APD my adequacy was tested by blood tests and a 24 hour urine collection. Because I have a good urine output my adequacy was way over adequate (2.7) (adequacy taget 1.9). Is this term adequacy the same as KT/V?

Now I do heamo and my KT/V is only .9 but they don't measure it against a 24 hour urine collection. At another clinic I recently dialysed at whilst on vacation they said that KT/V should always be measured with urine output to obtain a truly accurate figure.

I do 3 hours dialysis 3 times a week. My doctor  quotes this KT/V figure and keeps trying to push me into doing 4 hours which I refuse to do. I have always been suspicious of this one size fits all aproach to haemo and the fact that at least two separate NHS trusts operate different prcocedures for KT/V calculation has done nothing change that.

As a patient I want the kind of information that  I can be certain is a serious indicator of my dialysis adequacy and I thought that as KT/V is arrived at by mathematical equation then it must be definative. If there are NHS trusts changing this equation in any way then it would seem to me that the  the whole process a complete nonsense.

[paul.karen]

Ken i cant help with your dilemma although i understand where your coming from.
Just wanted to say hey and hope Hemo is doing ok with you.

[Jie]

For PD, Kt/V is for a week, whereas for HD, Kt/V is for each treatment. So they are not comparable. PD Kt/V should be greater than HD Kt/V because one can do three or more HD treatments per week.

[Des]

As I was explained to, the KT/v for HD is measured per session and it measures the successfulness of that particular dialysis session. It does not measure the workings of the kidney function as a whole.(the 24h urine sample and the kt/v should not be compared as the one checks the kidney function and the other the successfulness of dialysis)

Most units wants at least 1.3 KT/V per dialysis session. This will then ensure that enough toxins and fluid are removed from the blood. If they achieve less than that they have two options. 1. Increase the time on the machine. 2. Increase the pump speed.

Hope this helps.

[Zach]

Most units wants at least 1.3 KT/V per dialysis session. This will then ensure that enough toxins and fluid are removed from the blood. If they achieve less than that they have two options. 1. Increase the time on the machine. 2. Increase the pump speed.

The third option, though more expensive, is increase the size of the dialyzer.

[RenalSurvivorDotCA]

Most units wants at least 1.3 KT/V per dialysis session. This will then ensure that enough toxins and fluid are removed from the blood. If they achieve less than that they have two options. 1. Increase the time on the machine. 2. Increase the pump speed.

The third option, though more expensive, is increase the size of the dialyzer.

Zach - My Kt/v was usually between 1.30 and 1.4. My unit got some new dialysers (can't recall the name/number now) and tried them out on some of our patients, myself included. Each time I used it my Kt/v was 1.59 or better but I crashed every single time, tried different UF profiles but still crashed hard. We decided it just wasn't worth it to continue with the new dialyser and went back to the old one.

PS - Didn't really feel any different with Kt/v 1.59 than when it was 1.3.  Oh, well.

[Zach]

PS - Didn't really feel any different with Kt/v 1.59 than when it was 1.3.  Oh, well.

Not yet.

Remember you're in it for the long haul.