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ISRN NephrologyVolume 2013 2013, Article ID 341026, 8 pages

Clinical StudyDialysis Unit, Savonlinna Central Hospital, Keskussairaalantie 6, P.O. Box 111, 57101 Savonlinna, Finland

Received 30 August 2012; Accepted 17 September 2012

Academic Editors: L. Djukanovic and O. Schuck

Copyright © 2013 Aarne Vartia. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Dialysis dose is commonly defined as a clearance scaled to some measure of body size, but the toxicity of uraemic solutes is probably associated more to their concentrations than to their clearance. Methods. 619 dialysis sessions of 35 patients were modified by computer simulations targeting a constant urea clearance or a constant urea concentration. Results. Urea generation rate varied widely in dialysis patients, rather independently of body size. Dialysing to 1.2 in an unselected patient population resulted in great variations in time-averaged concentration TAC and average predialysis concentration PAC of urea 5.9–40.2 and 8.6–55.8 mmol-L, resp

Dialysing to equal clearance targets scaled to urea distribution volume resulted in higher concentrations in women. Dialysing to the mean HEMO-equivalent TAC or PAC 17.7 and 25.4 mmol-L required extremely short or long treatment times in about half of the sessions. Conclusions. The relation between and varies greatly and seems to be different in women and men. Dialysing to a constant urea concentration may result in unexpected concentrations of other uraemic toxins and is not recommended, but high concentrations may justify increasing the dose despite adequate , std EKR, or std .





Author: Aarne Vartia

Source: https://www.hindawi.com/



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