CHRONIC-HEMODIALYSIS - KT V OR SOLUTE REMOVAL INDEX TO EVALUATE THE EFFECTIVE DELIVERED DOSE/

A standard for quantifying the hemodialysis dose has not yet been defi ned, Many authors suggest the use of an alternative method to Kt/V: th e solute removal index (SRI). We compared three methods based on blood -side urea determinations with the direct quantification method (DDQ) for estimating the delivered dialysis dose, expressed as SRI as well a s Kt/V. Eight patients underwent three consecutive dialysis sessions, with the same dialytic efficiency. For each patient and each dialytic session the SRI and Kt/V were determined using the DDQ method and the single pool variable volume kinetic model, in ifs Classical version (S PVV) as well by using the postdialysis urea value determined 30 min af ter the end of the session (eqSPVV). Double pool Kt/V was also estimat ed by the Daugirdas-Schneditz rate equation. Our results showed that t he SPVV kinetic model significantly overestimated the delivered dialys is dose, the mean value of SRI and Kt/V were respectively 8.9% and 17% higher than those obtained by DDQ. The eqSPVV allowed the SRI to be e stimated with a difference of -0.3% and Kt/V with a difference of -2% in comparison with DDQ. By using the Daugirdas-Schneditz rate of equat ion, which does not require blood samples to be drawn after the end of the session, the difference in Kt/V value was 3%. Therefore, both the eqSPVV kinetic model and the Daugirdas method allow quantification of the delivered dialysis dose with results similar to those determined by DDQ, which cannot be routinely applied. Kt/V seems the best marker for dialytic doses quantification.