Assessment of hemodialysis adequacy: Correlation between online clearance monitoring and single pool Kt/V.

Abstract

Objectives: The aim of this study is to correlate the dose of dialysis delivered by both methods in the dialysis population in our developing country. Study Design: Cross Sectional study. Setting: Dialysis Centre at Doctor’s Hospital and Medical Center Lahore. Period: February 1, 2018 to April 30, 2018. Material & Methods: Using Fresenius 4008S machines equipped with OCM, we prospectively studied 41 hemodialysis patients. All patients were on hemodialysis for more than three months. Pre and post dialysis urea samples were collected for estimation of single pool Kt/V and compared with OCM. Results: The average age of the patients was 56.46 ± 13.82 years and the mean duration of dialysis was 28.9 ±35.22 months. Mean blood flow rate was 309.27 ±46.06 mL/min. The mean Kt/V was 1.51 ±0.216 (<p=0.001) and the mean OCM was 1.47 ±0.191 (<p=0.001). We found a positive correlation between the two parameters i.e a Pearson’s Correlation: 0.83 (<p=0.001) and an R square value of 0.645.We found that OCM is a good indicator of Kt/V. However, it underestimated Kt/V by 2.07%±8.53%. Conclusion: Online Kt/V calculated by ionic dialysance is a useful method to estimate dialysis dose without the need of blood samples. In clinical practice Kt/V is done on a monthly basis. Any change in the dialysis prescription would entail repeat labs. OCM can be performed at each dialysis session at no extra cost and in real time. Thus, it can prove to be a helpful and economical tool in the assessment of dialysis adequacy in the low income countries with limited resources.