Can the diverse family of dialysis adequacy indices be understood as one integrated system?
BACKGROUND
Dialysis adequacy indices are based on the amount of removed solute and systemized into two groups: (1) fractional solute removal (FSR, non-dimensional), and (2) equivalent continuous clearance (ECC, ml/min), which are expressed using appropriate reference method for solute concentration or mass such as: peak, peak average, time average, and treatment time average values.


METHODS
A review and critical analysis of the recent studies was performed.


RESULTS
The indices are mathematically interrelated and depend on kinetic parameters of the treatment, as device clearance, treatment time, solute distribution volume, dialysis frequency. In particular, KT/V and KT can be directly translated to FSR and ECC using the treatment time average reference method.


CONCLUSIONS
The diverse family of dialysis adequacy indices can be understood as one integrated system and be useful when assessing both standard treatment modalities and newer schedules and modalities (frequent dialysis, hybrid dialysis, dialysis in acute renal failure) of renal replacement therapies.
Institute of Biocybernetics and Biomedical Engineering, Trojdena 4, Warsaw, Poland. jacek.waniewski@ibib.waw.pl
Jacek
J
Waniewski
Malgorzata
M
Debowska
Bengt
B
Lindholm
D058186:Acute Kidney Injury / Q000628:therapy*; D001806:Blood Urea Nitrogen; D003198:Computer Simulation; D015314:Dialysis Solutions; D006801:Humans; D007700:Kinetics; D008954:Models, Biological; D010530:Peritoneal Dialysis / Q000592:standards; D006435:Renal Dialysis / Q000592:standards; D017582:Renal Replacement Therapy / Q000592:standards; D014508:Urea / Q000032:analysis*
D015314:Dialysis Solutions; D014508:Urea