title: What is a surrogate marker for optimal dialysis?
abstract: To find a surrogate marker to obtain optimal dialysis delivery from the viewpoint of nutrition, 180 maintenance hemodialysis patients (109 males/71 females) were enrolled between October 1999 and June 2006 at our kidney center. In the 449 hemodialysis treatments, ultrapure dialysis solutions and high-flux synthetic membranes were utilized. Parameters were measured by Kt/V(urea) and postdialysis urea rebound, Kc (the cellular membrane clearance for urea), urea clear space (CS), %creatinine generation rate, %lean body mass, total body water, and so on. We examined the correlation between dialysis delivery and nutritional parameters: Kt/V(urea) and postdialysis urea rebound were found to be strongly and negatively correlated with nutritional parameters. However, Kc and CS have shown positive and strong correlations with nutritional parameters such as %creatinine generation rate, %lean body mass, and total body water as well. In addition, the age factor was correlated with Kt/V(urea) positively, and it influenced Kc and CS negatively. As a conventional dialysis parameter, Kt/V(urea) did not reflect nutrition, but Kc was found to improve nutrition due to the increase of the dialysis delivery. Therefore, Kc might be a reliable surrogate marker for optimal dialysis.
authors.affiliation: Kidney Center, Eijinkai Hospital, Osaki City, Miyagi, Japan. naganokc@coral.ocn.ne.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Tomohito
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Ichiro
authors.initials: I
authors.lastname: Itagaki
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D015992:Body Mass Index; D002462:Cell Membrane / Q000378:metabolism*; D003404:Creatinine / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012044:Regression Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014508:Urea / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014508:Urea; D003404:Creatinine