Haemodialysis Adequacy: Ultraviolet vs. Calculated Methods
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To compare measuring methods of haemodialysis adequacy; realtime urea reduction ratio (RT-URR) and realtime Kt/V (RT- Kt/V) with calculated urea reduction ratio (C-URR) and calculated Kt/V (C-Kt/V), respectively, in end-stage kidney disease (ESKD) patients. STUDY DESIGN: Cross-sectional prospective study. Place and Duration of the Study: Department of Nephrology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan, from July to December 2023. METHODOLOGY: Patients on maintenance haemodialysis for more than 3 months via a well-functioning arteriovenous fistula were included, while patients with acute kidney injury and dialysis-related complications were excluded. Pre- and post-dialysis blood samples for urea measurement were sent to the laboratory. RT-URR and RT-Kt/V were measured by the NIKKISO-DBB-EXAES machine using the ultraviolet absorbance method on spent dialysate. By putting pre- and post-dialysis, urea values C-URR and C-Kt/V (Daugirdas formula) were calculated. RT-URR, C-URR, RT-Kt/V and C-Kt/V were analysed for correlation using the Bland-Altman graph. RESULTS: Fifty patients were included, with a mean age of 45.18 ± 12.25 years. The majority (n = 29, 58%) were male. Major cause of ESKD was hypertension (n = 27, 54%), followed by diabetes mellitus (n = 16, 32%). The mean duration of dialysis was 54.16 ± 31.74 months, and the majority of patients, 29 (58%), were on thrice weekly dialysis. A positive statistically significant correlation was found between C-URR and C-Kt/V with RT-URR and RT-Kt/V, respectively (p <0.001). A significant negative correlation was found for body surface area (BSA) with C-URR (p <0.001) and RT-URR (p = 0.013). Also, a significant negative correlation of BSA with C-Kt/V (p <0.001) and RT-Kt/V (p = 0.008) was found. CONCLUSION: RT-URR and RT-Kt/V, being strongly correlated with C-URR and C-Kt/V, can precisely tell about adequacy of haemodialysis. KEY WORDS: Renal dialysis, Haemodialysis, Home, Urea, Ultraviolet rays, Haemodialysis solutions.
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410134156