The monitoring of dialysis dose by ionic dialysance-based Kt reveals less dialysis adequacy than the Kt/V-UREA-based measurement in critically ill patients with acute renal failure

作者：Serra Cabanas N; Barros Freiria X; Garro Martinez J; Blasco Pelicano M; Maduell C****s F; Torras Rabasa A; Poch Lopez de Brinas E

来源：Nefrologia, 2010, 30(2): 232-235.

• Dialysis dose
• Hemodialysis
• Ionic dialysance
• Acute renal failure

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 (Kt/D) in the critically ill patient and to compare adequacy of dialysis dose between Kt/D 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 Kt/D 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 Kt/D reveals a lower degree of adequacy as compared to the traditional Kt/V-UREA method. The dynamic character of Kt/D monitoring can allow the adaptation of each dialysis sessions ("K" and/or "t") in order to achieve the recommended dose.

• 出版日期2010