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Author Topic: what is clearance?  (Read 2699 times)
texasstyle
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« on: November 13, 2009, 06:43:11 AM »

My husband's clearance was 73 last time. Does this mean how much of the toxins have been removed?  73... percent? Thanks guys
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willowtreewren
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« Reply #1 on: November 13, 2009, 06:59:40 AM »

According to Wikipedia normal rates of CC are:

 Men : 90–140 milliliters per minute (mL/min) or 1.78–2.32 milliliters per second (mL/sec)

Women: 87–107 mL/min or 1.45–1.78 mL/sec

A CC of 78 doesn't mean he is functioning at 78%.

It means that he is filtering at 78 mL per minute.
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Wife to Carl, who has PKD.
Mother to Meagan, who has PKD.
Partner for NxStage HD August 2008 - February 2011.
Carl transplanted with cadaveric kidney, February 3, 2011. :)
texasstyle
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« Reply #2 on: November 13, 2009, 07:52:52 AM »

Hi Willow. Oh my gosh, that's even more confusing! LOL. Actually I kinda-sorta get it.So it's not really relative to the amount of garbage (we can call it that right?) left in his system. His tech nurse said this was a good number. What, if any reasons, would there be to not filtering at the rate you should be? I originally thought it might of meant that he still had 27% of toxins still left in him after the session was done.
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Zach
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« Reply #3 on: November 13, 2009, 09:14:44 AM »

My husband's clearance was 73 last time. Does this mean how much of the toxins have been removed?  73... percent? Thanks guys

Since you husband is on hemodialysis, the word "clearance" usually refers to either the Kt/V measurement (1.2 is minimum, 1.6 is the standard target at many dialysis centers) or URR as a percentage (65% is minimum, 70% is the standard target at many dialysis centers).

URR is a direct measurement between the pre-BUN and post-BUN.

Beyond these numbers, length of the treatment duration time is also critical.  Four hour treatment time is better than three and a half hour treatment time.

Longer is better.

8)
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
willowtreewren
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« Reply #4 on: November 13, 2009, 09:34:49 AM »

Hmmm.

Carl's kt/V was .57 yesterday and they were very glad about that. ?????

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Wife to Carl, who has PKD.
Mother to Meagan, who has PKD.
Partner for NxStage HD August 2008 - February 2011.
Carl transplanted with cadaveric kidney, February 3, 2011. :)
RichardMEL
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« Reply #5 on: November 14, 2009, 06:25:19 AM »

like Zach says the URR clearance is a percentage measuring the urea levels between pre and post dialysis - basically a measure of how efficiently the dialysis process is cleaning out toxins. My last one was 75% which was a bit disappointing - I was at 82% at one point.
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3/1993: Diagnosed with Kidney Failure (FSGS)
25/7/2006: Started hemo 3x/week 5 hour sessions :(
27/11/2010: Cadaveric kidney transplant from my wonderful donor!!! "Danny" currently settling in and working better every day!!! :)

BE POSITIVE * BE INFORMED * BE PROACTIVE * BE IN CONTROL * LIVE LIFE!
dwcrawford
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« Reply #6 on: November 14, 2009, 06:53:06 AM »

I still don't understand!  OOOOh, numbers.  I guess you are ok as long as you stay in range but mine went way up this time from 1.6 to 3.56 and the rangge is 1.4 or higher (????).  So what happened?  Was I good?  ' splain it to me Zachie Boy!
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Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
Zach
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« Reply #7 on: November 14, 2009, 08:31:37 AM »

I still don't understand!  OOOOh, numbers.  I guess you are ok as long as you stay in range but mine went way up this time from 1.6 to 3.56 and the rangge is 1.4 or higher (????).  So what happened?  Was I good?  ' splain it to me Zachie Boy!

Sometimes there can be a mistake made by the technician who draws the post bloods.
All blood samples should be taken from the Arterial (red) port of the blood tubing.

If the bloods at the end of treatment are drawn from the Venious (blue) port, the values will be incorrectly higher, because the sample is coming directly from the filter and not your body.

It's not accurate.

8)
« Last Edit: November 14, 2009, 08:36:38 AM by Zach » Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
texasstyle
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« Reply #8 on: November 14, 2009, 02:24:08 PM »

I wish, I wish, I wish my husband was into his treatments like you guys are. You've learned so much but you have obviously been very pro active in regards to your own health. That is so great to see
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caregiver to husband using in-center dialysis 4 years
dwcrawford
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« Reply #9 on: November 14, 2009, 02:31:16 PM »

Texasstyle,  I'm only in it for 6 months now.  I depend on the staff at center,  my nephs and especially the guy called Zach.  But I'm learning something new almost every day.  Amazenly Awesome combination of specialists to rely on.
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Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
willowtreewren
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My two beautifull granddaughters

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« Reply #10 on: November 14, 2009, 05:11:08 PM »

Texasstyle,
We went to our clinic this past week and the neph says, "Well your kt/V looks good." as he reads the chart.

So miss smart mouth here says, "And what IS the kt/V?"

Otherwise, I would never have known, and dear hubby isn't as aggressive, er, assertive as I am when it comes to getting information out of doctors.

 :rofl; :rofl;
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Wife to Carl, who has PKD.
Mother to Meagan, who has PKD.
Partner for NxStage HD August 2008 - February 2011.
Carl transplanted with cadaveric kidney, February 3, 2011. :)
RichardMEL
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« Reply #11 on: November 14, 2009, 10:23:52 PM »

I wish, I wish, I wish my husband was into his treatments like you guys are. You've learned so much but you have obviously been very pro active in regards to your own health. That is so great to see

TS I think it's difficult for some people in this situation. It's such a lot to absorb and, most importantly, to accept. I mean all of us don't want to think that we have a terminal condition and that really IS serious and that stuff like labs and diets and whatever DO matter and DO affect our quality of life, health and overall mortality.

Hopefully your hubby can move to a more accepting stance on his condition and start to take more of an active role in his own treatment. As I often like to say to doctors and nurses who ask me why I want to know all the details - "Nobody cares about my body/health than *I* do!"

(it's also a bit funny when medical students are interviewing me as part of their assessments and I am telling them stuff I probably shouldn't "like oh I'm on Renagel as a phosphate binder, and sensipar to control the PTH" and more than 1 has looked at me and asked if I was a doctor or medical professional!  :rofl; Maybe next time I should tell them no, but my cat is....  :rofl;)

 :cuddle; :cuddle; :cuddle;
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3/1993: Diagnosed with Kidney Failure (FSGS)
25/7/2006: Started hemo 3x/week 5 hour sessions :(
27/11/2010: Cadaveric kidney transplant from my wonderful donor!!! "Danny" currently settling in and working better every day!!! :)

BE POSITIVE * BE INFORMED * BE PROACTIVE * BE IN CONTROL * LIVE LIFE!
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