Blood Urea Levels 30 Minutes Before the End of Dialysis Are Equivalent to Equilibrated Blood Urea

Bhaskaran, S; Tobe, Sheldon W.; Saiphoo, Carl; Moldoveanu, Andrei; Raj, Dominic S.; Manuel, Machelle

doi:10.1097/00002480-199709000-00086

Cited by 21 publications

(11 citation statements)

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“…Some reports using this simplified method have indicated relative good agreement with the original rate equation (23)(24)(25). Our data suggest that the simplified calculation overestimates rebound slightly (probably most of this is due to underestimation of the effect of urea generation, which becomes progressively more important at low postdialysis BUN values), as does the rate equation, possibly explaining the enhanced agreement between the simplified method and the original rate equation in some studies.…”

Section: Discussionsupporting

confidence: 54%

“…The median absolute deviation between the two measures was 0.052. two effects cancel. To allow comparison with such previous studies (23)(24)(25), we used the same simplified calculations with the HEMO data. ⌬Kt/V ϭ spKt/V Ϫ eKt/V was calculated by the simplified method and compared with the results of formal kinetic modeling.…”

Section: Rebound Using Simplified Estimates Of Spkt/v and Ekt/ Vmentioning

confidence: 99%

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Factors that Affect Postdialysis Rebound in Serum Urea Concentration, Including the Rate of Dialysis

Daugirdas¹,

Greene²,

Depner³

et al. 2004

Journal of the American Society of Nephrology

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Abstract. Previous studies have suggested that postdialysis urea rebound is related to K/V, the rate of dialysis, but a systematic analysis of factors that affect rebound has not been reported. With the use of 30-min and, in a subset, 60-min postdialysis samples, postdialysis urea rebound was measured to (1) determine how well previously proposed equations based on the rate of dialysis (K/V) predict rebound in a large sample of patients with varying characteristics, (2) determine whether other factors besides K/V affect rebound, and (3) estimate more precise values for coefficients in prediction equations for rebound. Rebound was calculated relative to both immediate and 20-s postdialysis samples to study early components of rebound unrelated to access recirculation. The equilibrated Kt/V (eKt/V) computed by fitting the two-pool variable volume model to the 30-min postdialysis sample agreed well with eKt/V based on the 60-min postdialysis sample. Using the pre-, post-, and 30-min postdialysis samples for 1245 patients with arteriovenous (AV) accesses, the median intercompartmental mass transfer coefficient (Kc) was 797 ml/min for rebound computed relative to the 20-s postdialysis samples and 592 ml/min relative to the immediate postdialysis samples. K/V was the strongest predictor of rebound among 22 factors considered. Other factors associated with greater rebound for 1331 patients using AV accesses or venous catheters included access type, black race, male gender, absence of congestive heart failure, greater age, ultrafiltration rate, and low predialysis or intradialysis systolic BP. Equations of the form eKt/V ϭ single-pool Kt/V Ϫ B ϫ (K/V) were fit to the data. With AV access, the optimum values for the slope term (B) were 0.39 and 0.46 (in h Ϫ1 ) for single-pool Kt/V calculated based on 20-s postdialysis or immediate postdialysis samples, respectively. For patients using venous catheters, the respective values for B were 0.22 and 0.29. Postdialysis urea rebound can be predicted with acceptable accuracy from a postdialysis sample using a zero-intercept, K/V-based rate equation. Several patient or treatment-specific factors predict enhanced or reduced rebound. Rate equation slope coefficients for K/V of 0.39 (AV access) and 0.22 (venous access) are proposed when a 15-to 20-s slow-flow method is used to draw the postdialysis blood. Slightly higher K/V slope coefficients (0.46 and 0.29, respectively) should be used if a shorter (e.g

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Section: Discussionsupporting

confidence: 54%

Section: Rebound Using Simplified Estimates Of Spkt/v and Ekt/ Vmentioning

confidence: 99%

Factors that Affect Postdialysis Rebound in Serum Urea Concentration, Including the Rate of Dialysis

Daugirdas¹,

Greene²,

Depner³

et al. 2004

Journal of the American Society of Nephrology

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“…The second, according to Smye (Smye et al, 1994), Daugirdas (Daugirdas et al, 1996), Tattersall (Tattersall et al, 1996), and Maduell (Maduell et al, 1997), is based on an intradialytic urea sample at 33% of the session time. Other methods use a urea sample taken 30 minutes before the end of the hemodialysis session, which corresponds to the 30-minute PDUR (Bhaskaran et al, 1997, Canaud at al., 1997. Finally, Artificial Neural Network (ANN) method was used as a predictor of equilibrated post-dialysis blood urea concentration (C eq ) (Guh et al, 1998;Azar et al, 2008a;Azar et al, 2009a).…”

Section: Problem Statementmentioning

confidence: 99%

Adaptive Neuro-Fuzzy Systems

Taher¹

2010

Fuzzy Systems

103

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“…Because of urea rebound, blood urea nitrogen (BUN) levels of systemic blood samples obtained 30 minutes after the completion of a hemodialysis treatment (+30‐min BUN) are higher than those collected promptly after a dialysis session is over [1,5–11]. Recently, however, it has been shown that the BUN concentrations of systemic blood specimens obtained 30 minutes prior to the end of a dialysis session (–30‐min BUN) are similar in value to their 30‐minute postdialysis (+30‐min BUN) counterparts [12,13]. In an attempt to determine whether such a relationship between BUN concentrations exists in patients dialyzed six times per week, as well as in those dialyzed three‐times weekly, the present study was carried out.…”

Section: Introductionmentioning

confidence: 99%

Use of Systemic Blood Urea Nitrogen Levels Obtained 30 Minutes before the End of Hemodialysis to Portray Equilibrated, Postdialysis Blood Urea Nitrogen Values

Ing

Blagg

Delano

et al. 2000

Hemodialysis International

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Blood Urea Levels 30 Minutes Before the End of Dialysis Are Equivalent to Equilibrated Blood Urea

Cited by 21 publications

References 0 publications

Factors that Affect Postdialysis Rebound in Serum Urea Concentration, Including the Rate of Dialysis

Factors that Affect Postdialysis Rebound in Serum Urea Concentration, Including the Rate of Dialysis

Adaptive Neuro-Fuzzy Systems

Use of Systemic Blood Urea Nitrogen Levels Obtained 30 Minutes before the End of Hemodialysis to Portray Equilibrated, Postdialysis Blood Urea Nitrogen Values

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