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 ORIGINAL ARTICLE
Year : 2012  |  Volume : 22  |  Issue : 5  |  Page : 333-339

The Kt/V by ionic dialysance: Interpretation limits


Service of Nephrology, Dialysis and Kidney Transplantation, Military Hospital of Instruction, Mohammed V Rabat, Morocco

Correspondence Address:
A Alayoud
Department of Nephrology, Dialysis and Transplantation Military Hospital, Rabat
Morocco
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.103906

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The availability of hemodialysis machines equipped with online clearance monitoring (OCM) allows frequent assessment of dialysis efficiency and adequacy without the need for blood samples. Accurate estimation of the urea distribution volume (V) is required for Kt/V calculated from OCM to be consistent with conventional blood sample-based methods. A total of 35 patients were studied. Ionic dialysance was measured by conductivity monitoring. The second-generation Daugirdas formula was used to calculate the Kt/V single-pool (Kt/VD). Values of V to allow comparison between OCM and blood-based Kt/V were determined using Watson formula (VWa), bioimpedance spectroscopy (Vimp), and blood-based kinetic data (Vukm). Comparison of Kt/Vw ocm calculated by the ionic dialysance and Vw (Kt/Vw ocm) with Kt/VD shows that using VW leads to significant systematic underestimation of dialysis dose by 24%. Better agreement between Kt/V ocm and Kt/VD was observed when using Vimp and Vukm. Bio-impedancemetry and the indirect method using the second-generation Daugirdas equation are two methods of clinical interest for estimating V to ensure greater agreement between OCM and blood-based Kt/V.






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Indian Journal of Nephrology
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Online since 20th Sept '07