COMPARISON OF Kt/V AND UREA REDUCTION RATIO IN MEASURING DIALYSIS ADEQUACY IN PAEDIATRIC HAEMODIALYSIS IN ENGLAND. Issue 2 (20th March 2014)

• Record Type: Journal Article
• Authors: Dunne, Nina; Campbell, Malcolm; Fitzpatrick, Maggie; Callery, Peter
• Is Part Of: Journal of renal care. Volume 40:Issue 2(2014:Jun.)
• Page Start: 117
• Page End: 124
• Publication Date: 2014-03-20
• Subjects: Kidneys -- Diseases -- Nursing -- Periodicals; Hemodialysis -- Periodicals; Kidney Diseases -- nursing -- Periodicals; Renal Replacement Therapy -- nursing -- Periodicals; 616.61
• DOI: 10.1111/jorc.12059
• Languages: English
• ISSNs: 1755-6678

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>SUMMARY</title> <sec id="jorc12059-sec-0001" sec-type="section"> <title>Background</title> <p>The National Kidney Foundation‐Dialysis Outcomes Quality Initiative (KDOQI) guidelines and the Renal Association recommend the use of either Kt/V or urea reduction ratio (URR) to measure haemodialysis adequacy.</p> </sec> <sec id="jorc12059-sec-0002" sec-type="section"> <title>Objectives</title> <p>To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of single pool Kt/V (spKt/V) and URR.</p> </sec> <sec id="jorc12059-sec-0003" sec-type="section"> <title>Design</title> <p>A service evaluation was conducted to establish current practices in measuring dialysis adequacy. A prospective longitudinal study was conducted to compare spKt/V and URR.</p> </sec> <sec id="jorc12059-sec-0004" sec-type="section"> <title>Participants</title> <p>Thirty‐two children were recruited consisting of 13 males and 19 females in five paediatric dialysis centres.</p> </sec> <sec id="jorc12059-sec-0005" sec-type="section"> <title>Results</title> <p>Inconsistencies were reported of the method of post‐urea sampling with 4 of the 10 centres using the KDOQI recommended sampling method. Five dialysis centres reported using URR and five reported using spKt/V. There were substantial differences between the two measures. Using URR suggested that up to 44% of children did not receive adequate dialysis, whereas measurement by spKt/V suggested no more than 6% of the same dialysis sessions were not adequate.</p> </sec> <sec id="jorc12059-sec-0006" sec-type="section"> <title>Conclusion</title> <p>One standard measure should be used to assess dialysis adequacy in paediatric centres in England. KDOQI guidelines were not consistently followed in obtaining a post‐urea blood sample and this procedure should be standardised.</p> </sec> </abstract>