Ramos GJM, Peña RJC

Language: Spanish
References: 28
Page: 76-82
PDF size: 171.26 Kb.

ABSTRACT

For many years, the Kt/V of urea was used as a tool for the measurement of the dialysis dose based on the kinetic model of urea. However, it has the following disadvantages: Kt/V was developed in a time when cellulose dialyzers with small pores were used; the evidence of the toxicity of urea is limited; urea clearance does not represent the kinetic behavior of other uremic molecules; in addition, the determination of Kt/V of urea in a single session is not representative of what happens in the rest of the sessions; the taking of blood samples for postdialysis BUN determination is frequently prone to errors, and finally, the Kt/V tends to over-estimate the dose of dialysis in patients with low body mass index or malnutrition. Using the Kt has advantages: both the K and the t are real machine measurements by dialysance (DI), not manipulated by the user, and they can be used in all dialysis sessions. The main recommendations in 1999 were made according to sex, with a minimum Kt of 40-45 L for women and 45-50 L for men. A study was recently published suggesting that increasing the dose of Kt three or more liters decreases mortality and hospitalization risk; however, more research with different populations is needed to confirm its usefulness.

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