KT V AND PCR - LONG-TERM MORBIDITY AND TY PE OF MEMBRANE/

In the present study we have analyzed the influence of the urea kineti c model as an index for dialysis prescription in our hemodialysis pati ents. We studied 149 patients (98 males, 51 females) during a 5 year p eriod (1989-1992). We calculated volume of urea distribution in relati on to sex and body surface. Biochemical, hematological, KT/V, PCR and TAC were determined monthly. Hemodialysis parameters were adjusted in order to obtain: KT/V > 1 and PCR 0.8-1,2 g/kg/day. Mortality and morb ility were also analyzed. Volume of urea distribution showed standar v alues in 50 % of the patients. In the period of study hemodialysis par ameters changed significantly. The number of patients with membrane su rface > 1,5 m2 increased 60 %, blood flow also increased and dialysis time decreased (p < 0,001). During the first year there was a signific ant increase of KT/V and PCR. This last parameter was higher (p < 0,01 ) in the group of patients dialyzed with AN 69 membranes fron the begi ning (25%) and in those who changed from-cuprophan to AN 69 (20 %). In these two groups morbility also decreased (p < 0,01). Patients dialyz ed with bicarbonate bath showed higher PCR values than acetate group ( p=NS). There were no significant differences when ESRD etiologies were analyzed. Percentual anual mortality did not change and diabetics tog ether to elderly patients (more than 70 years) showed the worst evolut ion. We conclude that the application of urea kinetic modeling in our patients as a dialysis prescription guide improve their outcome and mo rbility.