PubMed ID:
9987088
Public Release Type:
Journal
Publication Year: 1999
Affiliation: Division of Nephrology, University of California, Davis, Sacramento, USA. tadepner@ucdavis.edu
DOI:
https://doi.org/10.1046/j.1523-1755.1999.00269.x
Authors:
Greene T,
Daugirdas JT,
Depner TA,
Gotch FA,
Keshaviah PR,
Star RA
Studies:
Hemodialysis Study
The postdialysis blood urea nitrogen (BUN; Ct) is a pivotal parameter for assessing hemodialysis adequacy by conventional blood-side methods, but Ct is relatively unstable because of hemodialysis-induced disequilibrium. The uncertainty associated with this method is potentially reduced or eliminated by measuring urea removed on the dialysate side, a more direct approach that can determine adequacy from the fraction of urea removed and by substituting an estimate of the equilibrated postdialysis BUN (Ceq) for Ct. For a patient with a known urea volume (V), Ceq, the equilibrated Kt/V (eKt/V), and the solute removal index (SRI) can be calculated from the predialysis BUN (C0), total urea nitrogen removed (A), and V from simple mass balance calculations (dialysate/volume method). However, a theoretical error analysis showed that relatively small errors in A, C0, or V are magnified when SRI or eKt/V is calculated using this method, especially at higher eKt/V values (for example, if eKt/V = 1.4 per dialysis, a 7% dialysate collection error causes a 20% error in eKt/V).