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A new method for the calculation of dialysis dose from continuous measurements of dialysate urea concentrations has been developed. It is based on urea mass in the patient instead of plasma concentrations, and results in a measure of dialysis dose that has been named whole body Kt/V. The measured urea mass removal rate and the slope of the dialysate urea concentration curve are the key parameters needed for the calculations. No assumptions have to be made about urea distribution in the body (single or double pool, etc.). Blood sampling is not needed. This simplifies the logistics and eliminates the problems with rebound and timing in taking samples. The total urea mass present in the body before treatment is also obtained. It can be used directly, or in relation to body weight or water volume, as a measure of the level of urea in the body. This may serve as an alternative to pretreatment plasma concentration. If a pretreatment plasma urea concentration is available, the urea distribution volume can be calculated, which may be of separate clinical interest.

Whole body Kt/V from dialysate urea measurements during hemodialysis.