Dialysis adequacy explained

In nephrology, dialysis adequacy is the measurement of renal dialysis for the purpose of determining dialysis treatment regime and to better understand the pathophysiology of renal dialysis.^[1] It is an area of considerable controversy in nephrology.^[2]

In the US, the dominant way of measuring dialysis adequacy in Kt/V and based on the clearance of urea, though the relevance of this measurement is disputed.^[3]

Urea

Comparing normal to ERSD

The normal clearance of urea is approximately 100 ml/min. A patient getting a conventional hemodialysis treatment, without remaining residual function, has a urea clearance of 10-15 ml/min.

Notes and References

1. Mehta . Ankit N. . Fenves . Andrew Z. . 2010 . Hemodialysis Adequacy: A Review . Dialysis & Transplantation . en . 39 . 1 . 20–22 . 10.1002/dat.20392. free .
2. Jones . Clare B. . Bargman . Joanne M. . 2018 . Should we look beyond Kt / V urea in assessing dialysis adequacy? . Seminars in Dialysis . en . 31 . 4 . 420–429 . 10.1111/sdi.12684.
3. Ross Morton . A. . Singer . Michael A. . 2007-01-22 . The Problem with Kt/V: Dialysis Dose should be Normalized to Metabolic Rate not Volume: PROBLEM WITH KT/V . Seminars in Dialysis . en . 20 . 1 . 12–15 . 10.1111/j.1525-139X.2007.00232.x.