Summary:
Introduction: The burden of kidney disease patients requiring
renal replacement therapy is increasing day by day.
Hemodialysis (HD) constitutes the most common form of
renal replacement therapy (RRT) worldwide. Determining
the adequacy of hemodialysis, Urea kinetic modeling (UKM)
is an important tool for this. The aim of this study was to
determine hemodialysis adequacy by UKM.
Material & Methods: A total 137 patients were sampled in
dialysis center of Combined Military Hospital (CMH)
Dhaka. This was a cross sectional study. Data were collected
from predialysis, postdialysis and next predialysis blood
sample. Mean of adequacy parameters like single pool Kt/V
(spKt/V), urea reduction ratio (URR), time average
concentration of urea (TACurea) and normalized protein
catabolic rate (NPCR) were calculated and compared between
twice and thrice per week hemodialysis groups. Also
compared adequacy variables between groups who achieved
cutoff values and who did not achieve it.
Results: One hundred (72.99%) patients were on 8 hours/week
and 37 (27%) were on 12 hours/week hemodialysis session.
Only 21(21%) and 16(43%) could achieve spKt/V cut off value
among 8 hour and 12 hours group respectively. Eighty (58.39%)
patients had URR < 65% in this study. Blood flow e+250 ml/
min group had significantly better dialysis adequacy than blood
flow <250ml/min group, URR (81.31± 10.21 vs. 54.51 ± 11.52
and p-value <0.001), spKt/V (1.99 ± 0.41 vs. 1.41 ± 0.31 pvalue<
0.001) Thrice weekly hemodialysis group achieved better
adequacy than twice weekly group.
Conclusion: Frequency and blood flow of dialysis are
strongly associated with adequacy of hemodialysis as
evidenced by spKt/V and URR value. So to achieve
hemodialysis adequacy, increasing the frequency of dialysis
from two to three sessions per week is recommended.
Key words: Assessment, Hemodialysis adequacy, Urea Kinetic
Modeling (UKM).
(J Bangladesh Coll Phys Surg 2019; 37: 169-174)
DOI: http://dx.doi.org/10.3329/jbcps.v37i4.43345