[The monitoring of dialysis dose by ionic dialysance-based Kt reveals less dialysis adequacy than the Kt/V(UREA)-based measurement in critically ill patients with acute renal failure].
BACKGROUND
Measurement of dialysis dose by methods based on urea kinetics (Kt/VUREA) are hardly applicable to critical ill patients with acute renal failure (ARF). However, it is the base of the ADQI consensus recommendation for the target minimum dose.


OBJECTIVE
To evaluate the usefulness of the real-time measurement of delivered dialysis dose (Kt) by means of the ionic dialysance (KtID) in the critically ill patient and to compare adequacy of dialysis dose between KtID and traditional Kt/V(UREA).


METHODS
Prospective observational study in 17 critically ill patients with ARF requiring acute hemodialysis with a predefined prescription for the study (51 measures).


RESULTS
The mean delivered Kt/V(UREA) was 1.19 +/- 0.14, with 59% of the sessions with values equal or above the ADQI recommendation. On the contrary, the mean KtID values obtained was 37.6 +/- 1 l, with only 29.4% of the sessions being equal or greater than the recommended values.


CONCLUSIONS
Dialysis dose monitoring by means of KtID reveals a lower degree of adequacy as compared to the traditional Kt/V(UREA) method. The dynamic character of KtID monitoring can allow the adaptation of each dialysis session ("K" and/or "t") in order to achieve the recommended dose.
Serra Cabañas
N
N
Servicio de Nefrología y Trasplante Renal, Hospital Clínic, IDBAPS, Universidad de Barcelona.
Barros Freiría
X
X
Garro Martínez
J
J
Blasco Pelícano
M
M
Maduell Canals
F
F
Torras Rabasa
A
A
Poch López de Briñas
E
E
D058186:Acute Kidney Injury / Q000097:blood / Q000628:therapy*; D000368:Aged; D000465:Algorithms; D001331:Automation; D016638:Critical Illness; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D009994:Osmolar Concentration; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation / Q000706:statistics & numerical data; D012772:Shock, Septic / Q000097:blood / Q000628:therapy; D014508:Urea / Q000097:blood*
D015312:Hemodialysis Solutions; D014508:Urea