Kt/V

[pelagia]

I found this link about Kt/V and URR. 

http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysisdose/

Unfortunately, that information (2005) is considered by many folks out-of-date.

The HEMO study, which is the basis of the article, is seen as flawed--because it didn't consider increased time (8 hours vs. 3-4 hours.) as a factor for improved outcomes (and in the process increased Kt/V).

In the case of the HEMO Study, there was a high-dose group, with a target Kt/V of 1.65, and a standard-dose group, with a target Kt/V 1.25, both using either a low-flux or high-flux dialyzer.  The conclusion was that a Kt/V greater than 1.2 did not result in improved outcomes.

If the study had considered increased time (8 hours vs. 3-4 hours 3 x week), the greater Kt/V achieved would also have reflected the greater removal of the "middle molecules" and would have resulted in a conclusion that it did improve outcomes.

A more recent study from Turkey on in-center nocturnal hemodiaysis concludes:
   "For hemodialysis patients, undergoing dialysis for eight hours overnight, three times weekly, reduces the risk of death by nearly 80 percent, compared to conventional, four-hour dialysis."

Now that's a study you can believe in.



You can read more about the study in this IHD post:
http://ihatedialysis.com/forum/index.php?topic=11085.0

Oops, I only got as far as the definitions of Kt/V and URR.  I assume those are correct.   

I was not in anyway trying to argue against the benefits of nocturnal or slower, more frequent dialysis. 

[Zach]

Oops, I only got as far as the definitions of Kt/V and URR.  I assume those are correct.   

Definitions, yes.

Unfortunately, the internet doesn't correct out of date material.

 

[Angelicfury]

Last month kt/v was .88 and this month it was .91. Flow rate is around 450. Not sure what's going on but i'm not liking it. I'm at 3x for 4hrs as it is. I wonder if they have peppermint flavored ice chips. . . . .

[Zach]

Last month kt/v was .88 and this month it was .91. Flow rate is around 450. Not sure what's going on but i'm not liking it. I'm at 3x for 4hrs as it is.

Maybe you have some recirculation going on.

[RichardMEL]

Interestingly I got put on a FX100 dialyzer for a little while (because they ran out of 80's which I normally was on) and the staff were saying I'd have almost "100% clearance" with that. Don't know if it's true or not we didn't test the URR that time. Now I'm back to the 80.