ADEQUACY OF HEMODIALYSIS AND NUTRITION IN MAINTENANCE HEMODIALYSIS-PATIENTS - CLINICAL-EVALUATION OF A NEW ONLINE UREA MONITOR

Background, Recent developments in urea sensing monitoring shaw a good agreement between an-line and direct dialysis quantification which pe rmits evaluation of both effective dialysis efficiency and protein cat abolic rate of dialysis patients. Methods, Fifty chronic haemodialysis patients were enrolled in a prospective study using an automatic urea sensing monitor operating on spent dialysate (U.M. 1000, Baxter). Die tary protein intake (DPI) and energy intake (DE) were carefully evalua ted by a skilled dietitian over 1 week. During this run U.M. 1000 was used lo provide urea mass removed, effective K-t/V, and normalized nPC R. Blood samples were drawn pre- and post-dialysis for classical blood -based single pool K-t/V calculations at each session. Results, For al l patients results were as follows (mean +/- SD): Effective K-t/V 1.4 +/- 0.3, nPCR 1.2 +/- 0.3 g/Kg/day, DPI 1.2 +/- 0.3 g/Kg/day and DEI 3 0.1 +/- 7.2 Kcal/kg/day; blood-based single pool K-t/V 1.5 +/- 0.3. A strong correlation was found between nPCR and DPT for tile 50 patients over 1 week (r = 0.75, P < 0.0001) and between effective K-t/V and si ngle pool calculated K-t/V (r = 0.76). Conclusions, Urea Monitor 1000 is easy and convenient to use and there was a good correlation of the predialysis BUN and effective K-t/V with standard blood-side measureme nts. In stable haemodialysis patients who are not strongly catabolic o r anabolic, the urea monitor measurement of nPCR con-elated with DPI m easured by a 7-day dietary record.