title: Evaluation of dialysis adequacy in hemodialysis patients: A systematic review.
abstract: OBJECTIVE
  Hemodialysis is the common kidney replacement therapy in Iran. Doing an adequate and effective dialysis can improve patients' quality of life and reduce kidney failure complications. Additionally, dialysis quality is an important factor in reducing mortality in patients with chronic kidney failure. This systematic review has investigated the adequacy of dialysis in studies done on hemodialysis patients of Iran.
  
  
  METHODS
  All articles related to the dialysis adequacy in hemodialysis patients in English and Farsi (contemporary Persian) were identified by searching the related keywords in various electronic databases. According to the inclusion criteria 21 studies were identified. The results were analyzed using Stata software version 11.
  
  
  RESULTS
  A number of 6677 patients had been enrolled in 21 studies that were chosen for this systematic review. Based on the random effects model, the overall dialysis adequacy (KT/V) (K: clearance of urea, T: duration of dialysis, V: distribution of urea) more than 1.2 and confidence interval were 36.3% and 46.2-26.4, respectively. Also, based on random effects model more than 65% urea reduction ratio in all studies was 28.8% and the confidence interval was 43.3-14.4.
  
  
  CONCLUSIONS
  KT/V and urea reduction ratio were much less desirable in hemodialysis patients and the dialysis quality was also undesirable. It seems that inadequate dialysis prescription, use of inappropriate filters, low pump speed (blood flow speed), and the short duration and few times of dialysis are the major causes of this inadequacy.&nbsp.
authors: School of Nursing and Midwifery, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
authors: Hengameh
authors: H
authors: Barzegar
authors: Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors: Mahmoud
authors: M
authors: Moosazadeh
authors: Department of Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran.
authors: Hedayat
authors: H
authors: Jafari
authors: Department of Medical-Surgical Nursing, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors: Ravanbakhsh
authors: R
authors: Esmaeili
mesh_terms: D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis