« Back to list

Adequacy of quotidian hemodialysis

Am J Kidney Dis. 2003 Jul;42(1 Suppl):42-8
Adequacy of quotidian hemodialysis.
Suri R, Depner TA, Blake PG, Heidenheim AP, Lindsay RM.
Optimal Dialysis Research Unit, London Health Sciences Centre, London, Ontario, Canada

Background

Several methods exist to quantitate small-solute clearance by daily hemodialysis (HD) regimens, but these have not been empirically applied or compared.

Methods

• In the London Daily/Nocturnal Hemodialysis Study, dosing and adequacy of quotidian HD regimens, both short daily HD (n = 11) and long nocturnal HD (n = 12), were compared with conventional thrice-weekly HD (n = 22) using several models.
• Urea clearance was computed by percentage of reduction in urea, kinetic modeling (single-pool Kt/V [spKt/V]), Daugirdas rate equation (equilibrated Kt/V [eKt/V]), and Gotch standardized Kt/V (stdKt/V).

Results

• Results from this prospective comparative study showed that compared with conventional thrice-weekly hemodialysis, both types of quotidian hemodialysis resulted in significantly greater weekly urea clearances measured by stdKt, weekly spKt/V, and weekly eKt/V.
• Mean stdKt/V almost doubled in the nocturnal HD group, whereas the daily HD group showed a 20% increase in stdKt/V compared with conventional HD patients.

Conclusion

These results show that both quotidian HD regimens are more effective than conventional HD in improving weekly urea clearance measured by spKt/V, stdKt/V, and eKt/V.