Abstract

SERRA CABANAS, N. et al. Dialysis dose measurements of Kt by ionic dialisance reveals less dialysis adequacy than the Kt/V_UREA-based method in critically ill patients with acute renal failure. Nefrología (Madr.) [online]. 2010, vol.30, n.2, pp.232-235. ISSN 1989-2284.

Introduction: Measurement of dialysis dose by methods based on urea kinetics (Kt/V _UREA) are hardly applicable to critical ill patients with acute renal failure (ARF). However, it is the base of the ADQI consensus recommendation for the target minimum dose. Objetive: To evaluate the usefulness of the real-time measurement of delivered dialysis dose (Kt) by means of the ionic dialysance (KtID) in the critically ill patient and to compare adequacy of dialysis dose between KtID and traditional Kt/V_UREA. Material and methods: Prospective observational study in 17 critically ill patients with ARF requiring acute hemodialysis with a predefined prescription for the study (51 measures). Results: The mean delivered Kt/V _UREA was 1.19 ± 0.14, with 59% of the sessions with values equal or above the ADQI recommendation. On the contrary, the mean KtID values obtained was 37.6 ± 1 l, with only 29.4% of the sessions being equal or greater than the recommended values. Conclusions: Dialysis dose monitoring by means of KtID reveals a lower degree of adequacy as compared to the traditional Kt/V _UREA method. The dynamic character of KtID monitoring can allow the adaptation of each dialysis sessions ("K" and/or "t") in order to achieve the recommended dose.

Keywords : Dialysis dose; Ionic dialysance; Hemodialysis; Acute renal failure.

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