title: Determination of dialysis dose: a clinical comparison of methods.
abstract: BACKGROUND
  Guidelines recommend regular measurements of the delivered hemodialysis dose Kt/V. Nowadays, automatic non-invasive online measurements are available as alternatives to the conventional method with blood sampling, laboratory analysis, and calculation.
  
  
  METHODS
  In a prospective clinical trial, three different methods determining dialysis dose were simultaneously applied: Kt/V(Dau) (conventional method with Daugirdas' formula), Kt/V(OCM) [online clearance measurement (OCM) with urea distribution volume V based on anthropometric estimate], and Kt/V(BCM) [OCM measurement with V measured by bioimpedance analysis (Body Composition Monitor)].
  
  
  RESULTS
  1,076 hemodialysis patients were analyzed. The dialysis dose was measured as Kt/V(Dau) = 1.74 ± 0.45, Kt/V(OCM) = 1.47 ± 0.34, and Kt/V(BCM) = 1.65 ± 0.42. The difference between Kt/V(OCM) and Kt/V(BCM) was due to the difference between anthropometric estimated V(Watson) and measured V(BCM). Compared to Kt/V(Dau), Kt/V(OCM) was 15% lower and Kt/V(BCM) 5% lower. Kt/V(Dau) was incidentally prone to falsely high values due to operative errors, whereas in these cases OCM-based measurements Kt/V(OCM) and Kt/V(BCM) delivered realistic values.
  
  
  CONCLUSIONS
  The automated OCM Kt/V(OCM) with anthropometric estimation of urea distribution volume was the easiest method to use, but Kt/V(BCM) with measured urea distribution volume was closer to the conventional method.
authors.affiliation: BioArtProducts GmbH, Rostock, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ahrenholz
authors.forename: Petr
authors.initials: P
authors.lastname: Taborsky
authors.forename: Margot
authors.initials: M
authors.lastname: Bohling
authors.forename: Peter
authors.initials: P
authors.lastname: Rawer
authors.forename: Noureddin
authors.initials: N
authors.lastname: Ibrahim
authors.forename: Martin
authors.initials: M
authors.lastname: Gajdos
authors.forename: Petr
authors.initials: P
authors.lastname: Machek
authors.forename: Michaela
authors.initials: M
authors.lastname: Sagova
authors.forename: Hans
authors.initials: H
authors.lastname: Gruber
authors.forename: Pavel
authors.initials: P
authors.lastname: Moucka
authors.forename: Ivan
authors.initials: I
authors.lastname: Rychlik
authors.forename: Gerd
authors.initials: G
authors.lastname: Leimenstoll
authors.forename: Pavel
authors.initials: P
authors.lastname: Vyskocil
authors.forename: Gunter
authors.initials: G
authors.lastname: Toenne
authors.forename: Jindriska
authors.initials: J
authors.lastname: Possnickerova
authors.forename: Joerg
authors.initials: J
authors.lastname: Woggan
authors.forename: Werner
authors.initials: W
authors.lastname: Riegel
authors.forename: Helmut
authors.initials: H
authors.lastname: Schneider
authors.forename: Ralf
authors.initials: R
authors.lastname: Wojke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D014508:Urea / Q000378:metabolism
chemical_list: D014508:Urea