[ evaluation of dialysis adequacy by KTN in hemodialysis patients]

ABSTRACT

Patients with ESRD need adequate dialysis. According to DOQI guidelines, minimum dialysis dose by KT/V in patients under hemodialysis [HD] is 1.2 or greater. In a cross- sectional study, we evaluated the value of KT/V among HD patients in shahid Beheshti Hospital of Abadan, Iran. HD was performed for 3 to 4 hours, using synthetic dialyzer and the bicarbonate- based dialysate. Blood flow rate, dialysate flow rate and ultrafiltration rate were 250 to 300 cc /min, 500cc/min and zero or 1 to 3 liters, respectively. Blood sampling for BUN was done immediately before and after the dialysis session. We used the following equation to estimate the KT/V from the percent reduction in urea [PRU]. KT/V = [0.026 xPRU] - 0.460 54 HD patients [28 females and 26 males] with the mean age of 39 +/- 14.2 years were enrolled in the study. The most common cause of ESRD was hypertension [24.07%] followed by, unknown [22.22%], DM [18.51%], Chronic Glomerulonephritis [14.81%], urinary tract abstraction [12.96%] and poly cystic kidney disease [7.40%]. KT/V was less than 1.2 in 87.03 patients [n=47]. There was no significant difference in the valve of KT/V in men and women [P= 0.54] and in different hemoglobin concentration [p=0.58]. The results of the study show that the most of our HD patients have not received minimum dialysis dose and we should evaluate and correct its causes