Nephrol Dial Transplant (2001) 16: 1749-1752
© 2001 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Kt/V: finding the tree within the woods
Department of Internal Medicine, PO Box 5800, Maastricht, The Netherlands
Keywords: dialysis efficacy; Kt/V determination
Introduction
Dialysis efficacy is one of the predominant factors determining survival in haemodialysis patients. The index Kt/Vurea, which is a function of dialyser urea clearance, treatment time, and urea distribution volume, is by far the most commonly used marker for dialysis adequacy and was found to be related to morbidity and mortality in various studies [1,2]. Therefore, Kt/Vurea, or more commonly called Kt/V, is generally proposed as the predominant treatment parameter in influential guidelines and multi-centre studies [3,4]. Nevertheless, despite the fact that the concept of Kt/V has been introduced more than 15 years ago [1], there is still ample discussion about the best method to assess this parameter. The main problem is that the so-called single-pool methods assume that urea is present in one homogeneous distribution volume. This is actually not the case, as is evident from the
Which types of rebound can be distinguished?
How to compensate for urea rebound
Direct urea monitoring
Methods based on ionic dialysance
Conclusion
Editor's note
Notes
References