How to determine ionic dialysance for the online assessment of delivered dialysis dose

Filippo, Salvatore Di; Manzoni, Celestina; Andrulli, Simeone; Pontoriero, Giuseppe; Dell’Oro, Cesare; Milia, Vincenzo La; Bacchini, G.; Crepaldi, Monica; Bigi, Maria Carla; Locatelli, Francesco

doi:10.1046/j.1523-1755.2001.059002774.x

Cited by 36 publications

(28 citation statements)

References 16 publications

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“…Although there was some disagreement early on, K ID has more recently been shown to be representative of effective urea clearance corrected for cardiopulmonary and access recirculation. [3][4][5][6] Because K ID is measured daily, we hypothesized that dialysis adequacy could be monitored on a daily basis. First, we assumed that on the day spKt/V, K ID , and time on dialysis (t) were determined, we could manipulate these terms algebraically to calculate a surrogate volume of distribution of urea, V ID .…”

Section: Introductionmentioning

confidence: 99%

Estimating Dialysis Adequacy Using Ionic Dialysance

Carl

Feldman

2008

Renal Failure

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The aim of this study was to determine the efficacy and feasibility of estimating dialysis adequacy using ionic dialysance (ID). We retrospectively reviewed the medical records of patients receiving thrice weekly dialysis for an eight-month period at a single-center Veterans Affairs hospital. Dialysis adequacy was determined monthly using pre- and post-treatment BUN measurements to calculate the single pool Kt/V (spKt/V) with the formula set forth by Daugirdas. On the same treatment day, K(ID)t was determined by multiplying the average ID times the time (t) of the treatment. A surrogate volume, V(ID), was estimated by dividing K(ID)t by spKt/V using data from the first six months. During the subsequent two months, we compared dialysis adequacy estimated by urea-based spKt/V to ionic dialysance based K(ID)t/V(ID) utilizing V(ID). In the first month, K(ID)t/V(ID) estimations and the simultaneous spKt/V determinations averaged 1.55 +/- 0.36 and 1.59 +/- 0.42, respectively. In the second month, K(ID)t/V(ID) and spKt/V averaged 1.52 +/- 0.33 and 1.54 +/- 0.35, respectively. K(ID)t/V(ID) correlated well with spKt/V, as the slope was 0.85 (r = 0.95, p < 0.001). There was considerable intra-patient variability of K(ID), time, and K(ID)t/V(ID) with coefficient of variations (CV) of 8.4 +/- 4.3, 9.0 +/- 5.3, and 15.8 +/- 9.2, respectively. However, the CV for K(ID)t/V(ID) was similar to the CV for spKt/V (15.3 +/- 7.4). These results suggest that it is possible to estimate dialysis adequacy during every treatment using K(ID)t/V(ID). Furthermore, there is considerable variability in the delivered dialysis adequacy, suggesting that many sessions result in sub-optimal dialysis.

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Section: Introductionmentioning

confidence: 99%

Estimating Dialysis Adequacy Using Ionic Dialysance

Carl

Feldman

2008

Renal Failure

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“…Ionic dialysance (ID) may accurately estimate "effective" urea clearance [7][8][9] (i.e., dialyzer urea clearance corrected for total recirculation) [10]. It can be calculated simply by measuring the difference in the conductivity of the outlet dialysate at two different values of inlet dialysate conductivity [11,12].…”

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confidence: 99%

Ionic dialysance allows an adequate estimate of urea distribution volume in hemodialysis patients

Filippo

Manzoni

Andrulli

et al. 2004

Kidney International

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“…On-line clearance K also known as ionic dialysance measures the urea clearance of the dialyzer corrected for any effects of access and cardiopulmonary recirculation (Di Filippo et al 2001, Polaschegg, Steil et al 1993). The measurement is performed by producing a step change in dialysate inflow conductivity, i.e.…”

Section: On-line Clearancementioning

confidence: 99%