Influence of Kt/V and protein catabolic rate on hemodialysis morbidity. A long-term study.
Urea clearance over time, divided by volume of total body water (Kt/V) and protein catabolic rate (PCR), were calculated monthly in 88 long-term hemodialysis patients. Patients were divided into four groups: Group A (n = 40), Kt/V > 1.0 and PCR > 1.0 g/kg/day; Group B (n = 7), Kt/V > 1.0 and PCR < 1.0; Group C (n = 24), Kt/V < 1.0 and PCR > 1.0; and Group D (n = 17), Kt/V < 1.0 and PCR < 1.0. Various clinical, biochemical, and morbidity factors were compared. Group A had significantly less morbidity than did the other groups (p < 0.05). Blood urea nitrogen, serum creatinine, serum albumin, and phosphorus were lower in Group B than in the other groups (p < 0.05). These data suggest that determination of Kt/V and PCR is important for predicting dialysis morbidity and that they should be monitored together for adequacy of therapy and dialysis quality assurance.
Raja
R M
RM
Kraftsow Division of Nephrology, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141.
Ijelu
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G
Goldstein
M
M
D000368:Aged; D001834:Body Water / Q000378:metabolism; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009748:Nutrition Disorders / Q000150:complications; D011506:Proteins / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D014508:Urea / Q000378:metabolism*
D011506:Proteins; D014508:Urea