title: Comparison of Kt/V and urea reduction ratio in measuring dialysis adequacy in paediatric haemodialysis in England.
abstract: BACKGROUND
  The National Kidney Foundation-Dialysis Outcomes Quality Initiative (KDOQI) guidelines and the Renal Association recommend the use of either Kt/V or urea reduction ratio (URR) to measure haemodialysis adequacy.
  
  
  OBJECTIVE
  To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of single pool Kt/V (spKt/V) and URR.
  
  
  METHODS
  A service evaluation was conducted to establish current practices in measuring dialysis adequacy. A prospective longitudinal study was conducted to compare spKt/V and URR.
  
  
  METHODS
  Thirty-two children were recruited consisting of 13 males and 19 females in five paediatric dialysis centres.
  
  
  RESULTS
  Inconsistencies were reported of the method of post-urea sampling with 4 of the 10 centres using the KDOQI recommended sampling method. Five dialysis centres reported using URR and five reported using spKt/V. There were substantial differences between the two measures. Using URR suggested that up to 44% of children did not receive adequate dialysis, whereas measurement by spKt/V suggested no more than 6% of the same dialysis sessions were not adequate.
  
  
  CONCLUSIONS
  One standard measure should be used to assess dialysis adequacy in paediatric centres in England. KDOQI guidelines were not consistently followed in obtaining a post-urea blood sample and this procedure should be standardised.
authors.affiliation: University of Brighton, Sussex, UK.
authors.forename: Nina
authors.initials: N
authors.lastname: Dunne
authors.forename: Malcolm
authors.initials: M
authors.lastname: Campbell
authors.forename: Maggie
authors.initials: M
authors.lastname: Fitzpatrick
authors.forename: Peter
authors.initials: P
authors.lastname: Callery
mesh_terms: D000293:Adolescent; D001806:Blood Urea Nitrogen; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D019983:Guideline Adherence; D015312:Hemodialysis Solutions; D006436:Hemodialysis Units, Hospital; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000451:nursing*; D008297:Male; D012016:Reference Values; D006435:Renal Dialysis / Q000451:nursing*; D016896:Treatment Outcome
chemical_list: D015312:Hemodialysis Solutions
keywords: Adequacy; Dialysis; Kt/V; Paediatric; URR