Comparison of Kt/V and urea reduction ratio in measuring dialysis adequacy in paediatric haemodialysis in England

Nina Dunne, Malcolm Campbell, Maggie Fitzpatrick, Peter Callery

Research output: Contribution to journalArticle

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. Objectives: To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of spKt/V and URR. Design: 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. Participants: 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 four of the ten centres using the K/DOQI 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. Conclusion: 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.
Original languageEnglish
JournalJournal of Renal Care
Volume40
Issue number2
DOIs
Publication statusPublished - 1 Jun 2014

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England
Renal Dialysis
Urea
Dialysis
Pediatrics
Guidelines
Kidney
Longitudinal Studies
Prospective Studies

Keywords

  • Adequacy
  • Dialysis
  • Kt/V
  • Paediatric
  • URR

Cite this

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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. Objectives: To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of spKt/V and URR. Design: 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. Participants: 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 four of the ten centres using the K/DOQI 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. Conclusion: 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.",
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Comparison of Kt/V and urea reduction ratio in measuring dialysis adequacy in paediatric haemodialysis in England. / Dunne, Nina; Campbell, Malcolm; Fitzpatrick, Maggie; Callery, Peter.

In: Journal of Renal Care, Vol. 40, No. 2, 01.06.2014.

Research output: Contribution to journalArticle

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AU - Campbell, Malcolm

AU - Fitzpatrick, Maggie

AU - Callery, Peter

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N2 - 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. Objectives: To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of spKt/V and URR. Design: 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. Participants: 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 four of the ten centres using the K/DOQI 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. Conclusion: 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.

AB - 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. Objectives: To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of spKt/V and URR. Design: 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. Participants: 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 four of the ten centres using the K/DOQI 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. Conclusion: 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.

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