Reliability of Hemodialysis Adequacy Measured by Ionic Dialysance

Oh, Joon Seok; Kim, Sung Min; Sin, Yong Hun; Kim, Joong Kyung; Son, Young Ki; An, Won Suk; Kim, Seong Eun; Kim, Ki Hyun

Abstract

PURPOSE
Quantification of the dialysis dose is an essential element in the management of hemodialysis. The author investigates the reliability of hemodialysis adequacy measured by ionic dialysance (Online clearance monitoring(R), OCM). Because OCM is a non-invasive and instantly accessible method, it could be replaced Kt/V derived from single-pool variable volume urea kinetic model (UKM).
METHODS
Kt/V using UKM and OCM were measured simultaneously in 51 patients who have received hemodialysis therapy via arteriovenous fistula. The analysis of the data collected from 186 hemodialysis sessions were performed.
RESULTS
Kt/V of conventional hemodialysis, high efficiency hemodialysis and hemodiafiltration measured by UKM were 1.39+/-0.24, 1.41+/-0.23 and 1.53+/-0.17, and by OCM were 1.24+/-0.17, 1.26+/-0.19 and 1.39+/-0.19, respectively. The data of UKM were significantly higher than those of OCM (p=0.00). Also, there were strong positive correlations between UKM and OCM in hemodialysis (r=0.80, p=0.00), high efficiency hemodialysis (r=0.65, p=0.00) and hemodiafiltration (r=0.67, p=0.00).
CONCLUSION
The Kt/V using OCM measured by ionic dialysance provided slightly lower data than that of UKM derived from single-pool variable volume urea kinetic model, but it may be a reliable test to evaluate dialysis adequacy in conventional hemodialysis, high efficiency hemodialysis and hemodiafiltration.