Publication: Dialysis adequacy in ESRD patients on maintenance hemodialysis in a tertiary care center
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
Abstract
Introduction: Assessment of the hemodialysis adequacy is one of the key factors for measurement of quality of life in end stage renal disease since it can predict the outcome of this disease. In this study, we aimed to evaluate hemodialysis adequacy in Institute of Medicine, Kathmandu. This would provide a good background for effective future planning by healthcare authorities.
Methods: This is a cross-section observational study done in Hemodialysis Unit, Tribhuvan university teaching hospital, Kathmandu, a tertiary level referral hospital in Nepal. Hemodialysis sessions of 50 patients on maintenance hemodialysis were evaluated after written consent Demographic data along with length of hemodialysis, reuse of hemodialyzer, hemodialysis sessions per week and hemodialyzer membrane type were recorded for each patient. Urea reduction ratio (URR) and single pool kT/v (spKt/v) were calculated to determine hemodialysis adequacy.
Results: Bicarbonate-based solutions and low-flux membranes was used in all patients. Length of each hemodialysis sessions was 240 minutes. Thirty-nine (78%) patients were male and eleven (22%) patients were female. The mean spKt/V and URR were found to be (1.15 ±40.3) and (60.35 ±9.26%) respectively. A spKt/V more than 12 and urea reduction rate more than 65% were found in 42% and 34% of the end stage renal disease patients respectively.
Conclusions: This study showed hemodialysis inadequacy in more than half of the patients. Adequacy of hemodialysis can be obtained by increasing its frequency, avoiding multiple use of dialyzer and increasing blood flow rate.
Keywords: End stage renal disease, Urea Reduction Ratio, Single-pool Ki/V
Description
S Baral
Faculty, Endocrinology Unit, Department of Medicine, Institute of Medicine
V Pant
MD Resident doctor, Department of Biochemistry, Institute of Medicine
DS Shah
Professor and Head of Department of Nephrology, Department of Medicine, Institute of Medicine
Keywords
End stage renal disease, Urea Reduction Ratio, Single-pool Ki/V