[Dose and adequacy of hemodialysis measured by the urea reduction ratio (URR and Kt/V)]. / Doza i adekvatnost hemodijalize mjerena stopom redukcije uree (URR i Kt/V).

BACKGROUND: There are little reports about prescribed and delivered dose of haemodialysis (HD) in B&H. If we want to reduce acute and chronic HD complications and to improve whole result of patients treatment, it is necessary to routinely monitoring and measurement of delivered dose of HD. Prescribed and delivered dose of HD have to be equal or near equal. METHODS: Blood samples were taken after the long interval in a thrice-weekly regimen before and 10 min after ultrafiltration, using Slow Flow/Stop Pumping. We measured delivered and prescribed dose of HD by URR and Kt/V, and efficacy of HD by QE. The results were processing by computerized urea kinetic modelling program. RESULTS: The mean URR was 64.69%. Mean prescribed Kt/V was 1.25 +/- 0.16 and delivered 1.23 +/- 0.14, and QE 0.99 +/- 15. Delivered Kt/V and QE were positively associated (p < 0.001). QE was significantly associated with post HD urea, and sex, but not with treatment time. CONCLUSIONS: We suggest that Kt/V can serve as an important parameter in the dose of HD, and QE as a measure of dialysis "efficacy" in a single treatment of an individual patient.

[Bicarbonate versus acetate hemodialysis: effects on the acid-base status]. / Bikarbonatna naspram acetatne hemodijalize: ucinci na acido-bazni status.

BACKGROUND: Metabolic acidosis is an inevitable complication of chronic renal failure and one the major goals of haemodialysis (HD) treatment is correction of acidosis. The main aim of study was to compare effects of bicarbonate versus (vs) acetate HD on acid-base. METHODS: A sample of 36 patients (pts) was done, 20 males and 16 females, aged 52.4 +/- 12.7 years, duration on HD 46.8 +/- 40.2 months, 15 pts on acetate and 21 pts on bicarbonate HD. We determined the parameters of acid-base before and after HD, electrolyte status, Kt/V and URR. RESULTS: At start of HD: pH-7.33 +/- 0.04; pCO2-4.95 +/- 0.5 kPa; HCO3 19.1 +/- 1.9 mmol/L on bicarbonate HD vs. pH-7.33 +/- 0.03; pCO2-4.81 +/- 0.4kPa; HCO3(-)-18.7 +/- 2.0 mmol/L on acetate HD. At the end of session: pH-7.45 +/- 0.02; pCO2-5.07 +/- 0.4 kPa; HCO3(-)-26.3 +/- 1.5 mmol/L on bicarbonate HD vs. pH-7.43 +/- 0.03; pCO2-4.55 +/- 0.3 kPa; HCO3(-)-22.6 +/- 1.8 mmol/L on acetate HD. CONCLUSION: Bicarbonate as a physiological buffer is much efficient in correction of metabolic acidosis and should be preferred in HD treatment.