Original InvestigationsIn vivo effects of dialysate flow rate on Kt/V in maintenance hemodialysis patients
Section snippets
Patients
The effect of Qd on in vivo urea kinetics was examined in 23 maintenance hemodialysis (MHD) patients (8 women) after obtaining informed consent. All patients had intact arteriovenous fistulas and underwent dialysis regularly thrice weekly. Mean age ± SD was 63 ± 11 years, and the mean time from initiation of dialysis treatment was 52 ± 45 months. The underlying renal diseases were diabetic nephropathy (n = 8), chronic glomerulonephritis (n = 3), rapidly progressive glomerulonephritis (n = 1),
Effect of Qd on Kt/V
Measured mean Kt/Vsp at each of three Qds is shown for 23 MHD patients in Fig 1A.
Discussion
We examined in vivo the effects of three different Qds on delivered dose of dialysis, assessed by urea kinetics. It is shown that Qd may be an important variable in the prescription of dialysis modalities. To our knowledge, these data are the first to show in vivo that increasing Qd from 500 to 800 mL/min results in a greater gain of urea clearance than predicted by classic urea kinetic modeling formulas.
Because a correlation between Kt/V as a marker of dialysis adequacy and patient mortality
Acknowledgements
Acknowledgment: The authors thank the nurses and staff of the Homburg/Saar University Hospital Renal Dialysis Unit. This work could not have been successfully performed without their special efforts.
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Received March 23, 1999; accepted in revised form August 10, 1999.
Address reprint requests to PD Dr Martin K. Kuhlmann, Universität des Saarlandes, Innere Medizin IV, Nephrologie, D-66421 Homburg/Saar, Germany. E-mail: [email protected]