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Clin J Am Soc Nephrol. 2017 May 8;12(5):839-847. doi: 10.2215/CJN.08460816. Epub 2017 Mar 17.

The Use of a Multidimensional Measure of Dialysis Adequacy-Moving beyond Small Solute Kinetics.

Author information

1
Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
2
Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. christopher.chan@uhn.ca.

Abstract

Urea removal has become a key measure of the intensity of dialysis treatment for kidney failure. Small solute removal, exemplified by Kt/Vurea, has been broadly applied as a means to quantify the dose of thrice weekly hemodialysis. Yet, the reliance on small solute clearances alone as a measure of dialysis adequacy fails fully to quantify the intended clinical effects of dialysis therapy. This review aims to (1) understand the strengths and limitations of small solute kinetics as a surrogate marker of dialysis dose, and (2) present the prospect of a more comprehensive construct for dialysis dose, one that considers more broadly the goals of ESRD care to maximize both quality of life and survival. On behalf of the American Society of Nephrology Dialysis Advisory Group, we propose the need to ascertain the validity and utility of a multidimensional measure that moves beyond small solute kinetics alone to quantify optimal dialysis derived from both patient-reported and comprehensive clinical and dialysis-related measures.

KEYWORDS:

Dialysis Physiology; Dialysis dose; Patient Reported Outcomes; Urea Kinetics

PMID:
28314806
PMCID:
PMC5477210
DOI:
10.2215/CJN.08460816
[Indexed for MEDLINE]
Free PMC Article

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