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Ionic dialysance allows an adequate estimate of urea distribution volume in hemodialysis patients
- Source :
- Kidney International. (2):786-791
- Publisher :
- International Society of Nephrology. Published by Elsevier Inc.
-
Abstract
- Ionic dialysance allows an adequate estimate of urea distribution volume in hemodialysis patients. Background An adequate estimation of urea distribution volume (V) in hemodialysis patients is useful to monitor protein nutrition. Direct dialysis quantification (DDQ) is the gold standard for determining V, but it is impractical for routine use because it requires equilibrated postdialysis plasma water urea concentration. The single pool variable volume urea kinetic model (SPVV-UKM), recommended as a standard by Kidney Disease Outcomes Quality Initiative (K/DOQI), does not need a delayed postdialysis blood sample but it requires a correct estimate of dialyser urea clearance. Methods Ionic dialysance (ID) may accurately estimate dialyzer urea clearance corrected for total recirculation. Using ID as input to SPVV-UKM, correct V values are expected when end-dialysis plasma water urea concentrations are determined in the end-of-session blood sample taken with the blood pump speed reduced to 50 mL/min for two minutes (U pwt2′ ). The aim of this study was to determine whether the V values determined by means of SPVV-UKM, ID, and U pwt2′ (V ID ) are similar to those determined by the "gold standard" DDQ method (V DDQ ). Eighty-two anuric hemodialysis patients were studied. Results V DDQ was 26.3 ± 5.2 L; V ID was 26.5 ± 4.8 L. The (V ID –V DDQ ) difference was 0.2 ± 1.6 L, which is not statistically significant ( P = 0.242). Anthropometric volume (V A ) calculated using Watson equations was 33.6 ± 6.0 L. The (V A –V DDQ ) difference was 7.3 ± 3.3 L, which is statistically significant ( P Conclusion Anthropometric-based V values overestimate urea distribution volume calculated by DDQ and SPVV-UKM. ID allows adequate V values to be determined, and circumvents the problem of delayed postdialysis blood samples.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
single pool urea kinetic model
Models, Biological
Hemodialysis Solutions
chemistry.chemical_compound
Renal Dialysis
anthropometric-based urea distribution volume
medicine
Humans
Urea
Dialysis
Distribution Volume
Volume of distribution
Chromatography
Kinetic model
Chemistry
clinical trial
Reference Standards
Surgery
direct dialysis quantification
ionic dialysance
Volume (thermodynamics)
Nephrology
Kidney Failure, Chronic
Hemodialysis
Subjects
Details
- Language :
- English
- ISSN :
- 00852538
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Kidney International
- Accession number :
- edsair.doi.dedup.....cdef48f56f6a06f8219724d83a64006b
- Full Text :
- https://doi.org/10.1111/j.1523-1755.2004.00804.x