spKt/V?

[cat]

At dialysis this morning, the social worker gave each of us a wonderful little booklet entitled “Do you feel as good as you should?”  Wow!  I read it cover to cover as soon as I got home.     It instructs us to check our lab reports for the spKt/V.  Immediately, I pulled out my lab reports for the last nine months.  It even gave us the number that would be ideal.  I cannot find anything even remotely like spKt/V on there.  So I Googled it and found lots of articles (I even found this wonderful formula:  V dC/dt=-K*C+m).  I now know what it is I am looking for:  the measure of the adequacy of my treatment but I have no idea where it might appear on my lab report.  I guess I will have to ask on Thursday.  In the meantime, does anyone know what other letters might be used to indicate this on the lab report?

[BigSky]

Your unit may not do Kt/V.  They may go by URR.

Ours uses both  Kt/V and URR. 

On our lab report it is listed as Kt/V

[dwcrawford]

What does it mean?  Mine has it and she told me but I forget....

[cat]

Thanks, BigSky.  I do have URR on my report.  It is above what the booklet says is "adequate" (1.2 minimum).  I guess this means I am getting good results from dialysis.

dw, it is supposed to measure how successful dialysis is for you - I think.

[willowtreewren]

According to Wikipedia:

In medicine, Kt/V is a number used to quantify hemodialysis and peritoneal dialysis treatment adequacy.

    * K - dialyzer clearance of urea
    * t - dialysis time
    * V - patient's total body water

In the context of hemodialysis, Kt/V is a dimensionless number. In peritoneal dialysis, it is dimensionless only by definition.

It was developed by Frank Gotch and John Sargent as a way for measuring the dose of dialysis when they analyzed the data from the National Cooperative Dialysis Study.[1] In hemodialysis the US National Kidney Foundation Kt/V target is 1.3, so that one can be sure that the delivered dose is at least 1.2.[2] In peritoneal dialysis the target is 2.0/week.[2]

[dwcrawford]

Yea, Aleta... That is explains it so clearly (NOT).  Who you think you're talking to?  a Montessorri Graduate?

Mine was 1.5.  Optimal 1.4.  "My blood is being cleaned well.  I should feel better and live longer."

[willowtreewren]

Yea, Aleta... That is explains it so clearly (NOT).  Who you think you're talking to?  a Montessorri Graduate?

 

I got a kick out of:

In the context of hemodialysis, Kt/V is a dimensionless number. In peritoneal dialysis, it is dimensionless only by definition.

Like, HUH?

[BigSteve]

I was told my Kt/V goal number for PD is 1.7. I am still below which is who I am now doing one mid
day excange in addition to nighttime cycler. I asked today in PD clinic about extending my time on
the cycler instead of the manual.

[dwcrawford]

So good number differ from method to method? I didn't realize that.  I have so much to learn

[BigSky]

Thanks, BigSky.  I do have URR on my report.  It is above what the booklet says is "adequate" (1.2 minimum).  I guess this means I am getting good results from dialysis.

dw, it is supposed to measure how successful dialysis is for you - I think.

Kt/V should be at least 1.2

URR should be at least 65%

Have seen information that  recommended diabetics have a Kt/V of 1.7

[kitkatz]

My KT/V is 3.6! Hot damn!

[aharris2]

My KT/V is 3.6! Hot damn!

  Nocturnal !!!
             

[Savemeimdtba]

Last time I checked my Kt/v was 2.9 - I'll take it!

edit: Well, now it's 4.7

[BigSky]

Last time I checked my Kt/v was 2.9 - I'll take it!

edit: Well, now it's 4.7

Thats pretty good.

I might add that PD patients should have a minimum of 2.0 Kt/V.

[BigSteve]

As I stated earlier in this topic, both my lab reports and my PD nurse say that my Kt/V should be 1.7.
Where are you getting your information, BigSky? Next month I will go on 10 hours on cycler and no
mid day exchanges.

[dwcrawford]

I've just found out that I should have higher clearance based on the lab.  My dietician told me that generally over all it is 1.2 but that Davita aims for 1.7 and that is hemo.  More is better, right....  I know nothing however....

[BigSky]

As I stated earlier in this topic, both my lab reports and my PD nurse say that my Kt/V should be 1.7.
Where are you getting your information, BigSky? Next month I will go on 10 hours on cycler and no
mid day exchanges.

I read it once some time ago in the K/DOQI practice guidelines.



As to 1.7, some  say 1.7 because some study showed there was no significant better outcomes over those who had a minimum of 1.7 vs 2.0 and that having a 1.7 may preserve more residual  kidney function.

[Jenabcd]

I'm curious...  does anyone know that if a person has a Kt/V of 3 or 4+,  and they look for a minimum of 1.7, does that mean that the person can cut back on dialysis?  Is there such a thing as too much?

[Zach]

I'm curious...  does anyone know that if a person has a Kt/V of 3 or 4+,  and they look for a minimum of 1.7, does that mean that the person can cut back on dialysis?  Is there such a thing as too much?

A Kt/V of 3 or 4 for a person on standard, in-center 3x week hemodialysis is most likely a false reading.

The blood must be drawn at the end of treatment from the arterial port (red) of the blood line --coming directly from your body-- after the blood pump speed has been reduced.

If the blood sample is taken from the venous port (blue), it comes directly from the filter and is not correct.
Always be vigilant!

Now, to determine a URR, the bloods are drawn pre-dialysis and post-dailysis.

Also, a Kt/V 1.2 is the bare minimum.  As dwcrawford has posted, Davita aims for 1.7 which is better.

But nocturnal hemodialysis provides considerably better clearances (URR & Kt/V) because it is longer treatment -- the "t" part of Kt/V.



More info:
http://www.kidney.org/professionals/KDOQI/guideline_upHD_PD_VA/hd_guide4.htm

[kitkatz]

Yes, Nocturnal gives me a KT/V between 2.7 and 3 usually.

[Zach]

Yes, Nocturnal gives me a KT/V between 2.7 and 3 usually.

Nocturnal is so much better than standard, in-center 3x week hemodialysis.

[sico]

My Kt/V is 2.0 so they didn't change my PD. So is this the minimum? Like if it dropped next time around would i need more dialysis?

[paul.karen]

Sico i think the national standard is 1.7.  My clinic has its own standard which is 1.9  I just had a KT/V test and my number was 2.8 if i recall.

So if you drop under 2.0 depending on your clinic they may throw an extra exchange in during the night.  Your nurse should be able to tell you for sure.

[BigSteve]

1.7 is what my clinic said was the minimum. I just got over that 2.1 at my last lab, so no mid-day
manual exchanges only 10 hours at night.