title: A comparison of laboratory values in pediatric hemodialysis patients: does day of the week matter?
abstract: BACKGROUND
  The National Kidney Foundation Dialysis Outcomes Quality Initiative (NKF-K/DOQI) guidelines recommend the delivered dose of hemodialysis (HD) be measured no less than monthly by checking Kt/V (K is effective urea clearance, t is minute and V is urea distribution). To date, no studies have explored whether the day of the week for checking maintenance HD laboratory studies impacts dialysis dosing.
  
  
  METHODS
  Data were collected at two HD facilities on 19 patients, ages ≤ 21 years receiving maintenance HD thrice weekly over a consecutive 6-month period. Data obtained from the Monday and Wednesday of each full third week of the month included dialysis vintage, ultrafiltration volume, serum electrolytes, hemoglobin and clearances.
  
  
  RESULTS
  Kt/V and K+ were significantly different between Monday and Wednesday (P = 0.013 and P = 0.047, respectively).
  
  
  CONCLUSIONS
  Due to variability in values based on the day of laboratory evaluations, the dialysis provider must consider the impact of this on the quality of patient care when prescribing dialysis. Research on a larger scale needs to be conducted to allow for better decision-making capabilities in the chronic HD population.
authors: Division of Pediatric Nephrology, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Christina
authors: C
authors: Nguyen
authors: Dale
authors: D
authors: Bednarz
authors: Michael E
authors: ME
authors: Brier
authors: Abubakr
authors: A
authors: Imam
authors: Deepa H
authors: DH
authors: Chand
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001774:Blood Chemical Analysis; D002648:Child; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D015314:Dialysis Solutions / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006436:Hemodialysis Units, Hospital; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D007677:Kidney Function Tests; D007700:Kinetics; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D011786:Quality Control; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome; D014508:Urea / Q000378:metabolism*; D015430:Weight Gain
chemical_list: D015314:Dialysis Solutions; D006454:Hemoglobins; D014508:Urea; D003404:Creatinine; D011188:Potassium