USE OF OPTIMAL DIALYZER FOR HEMODIALYSIS PROCEDURE AMONG PATIENTS ON MAINTENANCE HEMODIALYSIS THRICE WEEKLY

Abstract

Background: Hemodialysis adequacy is essential for effective removal of uremic solutes and is commonly assessed using urea reduction ratio (URR) and Kt/V. Objective: To determine Kt/V, URR, and one-month mortality among patients receiving maintenance hemodialysis three times weekly through an optimal dialyzer. Methodology: The descriptive case series was carried out in the Dialysis Unit of Department of Nephrology at Sir Ganga Ram Hospital, Lahore, from 15th January to 15th June 2017. Patients with end stage renal disease (ESRD) on maintenance hemodialysis (MHD) were consecutively recruited from the center for a total of 170 patients aged 18-65 years. Pre and post dialysis urea measurements were performed and expected clearance, URR and Kt/V were calculated. Patients were followed up for a month for mortality. The data were analyzed with SPSS version 23.0. Results: Among 170 patients, 127 (74.70%) were male and 43 (25.30%) were female, with a mean age of 43.59 ± 12.83 years. The mean expected clearance was 196.32 ± 39.16, mean URR was 66.74 ± 9.26%, and mean Kt/V was 1.54 ± 0.43. URR ≥65% was achieved by 91 (53.53%) patients, while Kt/V ≥1.3 was achieved by 116 (68.24%). URR was significantly associated with gender (p<0.001) and dialysis duration (p=0.018), while Kt/V was significantly associated with gender (p=0.032) and dialysis duration (p=0.041). No mortality occurred during one-month follow up (0/170, 0.00%). Conclusion: Routine monitoring of URR and Kt/V can help assess delivered dialysis adequacy and identify patients requiring optimization of dialysis therapy.