Daily dialysis Kt/V and flexible schedules: is it possible to control efficiency, when and how?
BACKGROUND
Daily hemodialysis is a promising treatment schedule but uniform criteria for defining efficiency are lacking.


METHODS
On our daily dialysis (DD) schedule, duration is flexible (2-3 hours, patients are free to add up to 30 min/session), Qb 250-350 mL/min; dialyser 1.6-1.8 m2. Study was performed on 12 pts on DD for > or = 2 months, with > or = 4 Kt/V on subsequent days, tested in the same laboratory.


OBJECTIVE
To evaluate variability and identify a simple method for weekly calculation, Kt/V was assessed for 133 sessions.


RESULTS
On flexible DD, variability of Kt/V-session is high (relative error 4.9%-22%). On flexible schedules, within the time range chosen (2-3 hours) variability of average hourly Kt/V is lower (standard deviation: min (0.014; max (0.052 hour, relative error 4.9%-10%) allowing calculation of weekly Kt/V (averaging 3 sessions: relative error < 6%) suitable for clinical practice.


CONCLUSIONS
Flexible schedules, allowing patients to increase treatment time, are an interesting clinical option, but a challenge for Kt/V assessment.
Piccoli
G B
GB
University of Torino, Italy. gbpiccoli@hotmail.com
Calderini
M
M
Bechis
F
F
Pacitti
A
A
Vischi
M
M
Iacuzzo
C
C
Mezza
E
E
Gai
M
M
Anania
P
P
Iadarola
A M
AM
Buniva
C
C
Jeantet
A
A
Segoloni
G
G
D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006437:Hemodialysis, Home / Q000592:standards; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D006435:Renal Dialysis / Q000592:standards*; D014508:Urea / Q000378:metabolism*
D014508:Urea