ROLE OF UREA KINETIC MODELING IN THE DOSE OF DIALYSIS PRESCRIPTION - A COMPARATIVE-STUDY OF 2.703 PATIENTS

The appropiate dose of dialysis prescription remains controversial. Ac cording to urea kinetic modeling (UKM) Kt/V and pcr are the most accur ate index of dialysis adequacy. The purpose of the present study was t o evaluate the role of UKM in the dose of dialysis prescription and it s influence on morbidity, considering the recent modifications introdu ced into the routine dialysis procedure, such as: synthetic membranes, increase in blood flow rate, new modalities of hemodiafiltration, etc . Questionaries were mailed to all National Dialysis Units, 3,361 were returned and 2,703 selected which supplied the following requested in formation: age, sex, weight, height, months on dialysis, hours/week of dialysis, blood flow, type of dialyzer, mid-week BUN pre and post-dia lysis, standard biochemistry (creatinine, hemoglobin, potassium and ph osphorus), urine urea and volume, admissions and total number of days of hospitalization/year. Upon data collection, body surface area, Kt/V , pcr and TAC were always calculated by the same researcher. The urea distribution volume was estimated from anthropomorphic measurements (W atson formula). According to the values of Kt/V (1.08), pcr (1.14) and TAC (54), the majority of patients were on a recomended dialysis pres cription, in spite of a reduced number of hours, 10.6 hours/week. The main cause of hospitalization was related to vascular access complicat ions (21 %). Patients who were more at risk of being hospitalized were older, had less Kt/V, lower, serum creatinine levels, and had spen mo re time on dialysis.