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Use of ionic dialysance to calculate Kt/V in pediatric hemodialysis
Author(s) -
Marsenic Olivera,
Booker Kristi,
Studnicka Kathleen,
Wilson Donna,
Beck Ann,
Swanson Tiffany,
Henry Dwayne,
Turman Martin
Publication year - 2011
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2011.00595.x
Subject(s) - kt/v , hemodialysis , medicine , nomogram , nuclear medicine , urology , analytical chemistry (journal) , surgery , chromatography , chemistry
Online clearance ( OLC ) monitor measures conductivity difference between dialysate entering and leaving the dialyser. Derived ionic dialysance ( ID ) represents effective urea clearance from which Kt/V is calculated, allowing Kt/V monitoring at every treatment without blood sampling. We tested ID accuracy in children and provide recommendations for its use. Using F resenius machines 2008 K with built‐in OLC monitors, we studied 45 hemodialysis ( HD ) sessions and 168 calculated Kt/V results in 11 patients. Urea distribution volume ( V ), needed to calculate Kt/V from ID , was estimated using three methods: Mellits and Cheek ( MC ), KDOQI recommended total body water nomograms ( TBWN ) and OLC ‐derived independent from tested HD sessions. Reference spKt/V from pre‐ and post‐ HD BUN ( D augirdas) was compared with Kt/V calculated from ID using three different estimated V's. ID was accurate in calculating Kt/V in children when V derived from OLC was used ( P = 0.42), with absolute error 0.14 ± 0.12. If TBWN ‐derived V was used, Kt/V was consistently underestimated by 0.32 ± 0.22. TBWN ‐derived V can still be recommended for use with OLC for monitoring trend in Kt/V , if underestimation of spKt/V of average 0.3 is accounted for. MC ‐derived V results in even greater underestimation of spKt/V and therefore cannot be recommended for use with OLC .