title: Are dialysis adequacy indices independent of solute generation rate?
abstract: KT/V is by definition independent of solute generation rate. Alternative dialysis adequacy indices (DAIs) such as equivalent renal clearance (EKR), standard KT/V (stdKT/V), and solute removal index (SRI) are estimated as the ratio of solute mass removed to an average solute mass in the body or solute concentration in blood; both nominator and denominator in these formulas depend on the solute generation rate. Our objective was to investigate whether and under which conditions the alternative DAIs are independent of solute generation rate. By using general compartment modeling, we show that for the metabolically stable patient (in whom the solute generated during the dialysis cycle, typically, 1 week, is equal to the solute removed from the body), DAIs estimated for the dialysis cycle are in general independent of the average solute generation rate (although they may depend on the pattern of oscillations in the generation rate). However, the alternative adequacy parameters (such as EKR, stdKT/V, and SRI) may depend on solute generation rate for metabolically unstable patients.
authors: From the *Department for Mathematical Modelling of Physiological Processes, Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland; and †Divisions of Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors: Jacek
authors: J
authors: Waniewski
authors: Malgorzata
authors: M
authors: Debowska
authors: Bengt
authors: B
authors: Lindholm
mesh_terms: D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D006435:Renal Dialysis / Q000592:standards*