Comparative survival analysis of urea kinetic based indices.
BACKGROUND
Although urea kinetic modeling indices for measuring dialysis dose are recommended by world expert groups, it is not quite clear whether some of these are superior in predicting the outcome over others. This prospective, single-center study was carried out with the aim to compare predictive value of different indices and methods of measuring dialysis dose.


METHODS
The analysis included 93 anuric patients having been on hemodialysis for at least 2 years who were followed-up for 75-months. The dialysis dose was measured by Kt/V (formal UKM, 3 and 2 urea samples), Kt/V (Daugirdas), Kt/V (Lowrie), eKt/V (Daugirdas), URR and TAC urea.


RESULTS
Correlations between dialysis indices and survival time were significant for all indices (p<0.01) except for TAC. All indices, except for TAC urea, were significant predictors of mortality (multivariate Cox regression analysis; p<0.01) and differences of significant levels among these colinear parameters were small.


CONCLUSIONS
All examined indices except for TAC urea were highly predictive of patient mortality. Daugirdas and Lowrie simplified Kt/V indices are as predictive of all-cause mortality as more complex formal UKM methods in long-term patients on a 3x4h/week schedule.
Stosovic
M
M
Department of Nephrology, University Clinical Center, Belgrade, Serbia and Montenegro. milanst@eunet.yu
Stanojevic
M
M
Radovic
M
M
Naumovic
R
R
Jovanovic
D
D
Simic
S
S
Marinkovic
J
J
Stankovic
S
S
Djukanovic
L J
LJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D001002:Anuria / Q000401:mortality* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D010758:Phosphorus / Q000378:metabolism; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D016019:Survival Analysis; D014508:Urea / Q000378:metabolism; D015022:Yugoslavia / Q000453:epidemiology
D015312:Hemodialysis Solutions; D010758:Phosphorus; D014508:Urea