| Ionic dialysance and the assessment of Kt/V: the influence of different estimates of V on method agreement. | |
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MedLine Citation:
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PMID: 17550929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Ionic dialysance was recently introduced as a means to assess Kt/V (K(ID)t/V). With this method, urea distribution volume (V) has to be estimated. The primary aim of the present study was to assess the agreement between equilibrated Kt/V assessed by urea kinetic modelling (eKt/V) with K(ID)t/V taking into account different estimates of V, and to assess the monthly variation in V. Secondly, the mechanisms behind the intra-treatment changes in ionic dialysance and inter-treatment variability of K(ID)t/V were assessed. METHODS: Sixty-six patients were included. eKt/V was estimated using 30 min post-treatment sampling in the second generation Daugirdas equation. V was assessed by the formulae of Watson and Chertow (V(Watson); V(Chertow)), double-pool urea kinetic modelling (V(UKM)) and by ionic dialysance (V(IOD)) [Diascan; Hospal(R)]. RESULTS: The use of V(UKM) or V(IOD) instead of V(Watson) or V(Chertow) improved the relation between eKt/V and K(ID)t/V (both r = 0.93; P < 0.001 vs r = 0.84 and r = 0.81; P < 0.001). Mean values of eKt/V (1.19 +/- 0.21), K(ID)t/V(UKM) (1.19 +/- 0.30) and K(ID)t/V(IOD) (1.21 +/- 0.25) were comparable. Intra-class correlation coefficient of V(IOD) was 0.87 with a 1-month interval and <0.75 after 2 and 3 months. Intra-class correlation coefficient of V(DP) was 0.79 with a 1-month interval and <0.75 after 2 and 3 months. Inter-treatment variation in K(ID)t/V during six consecutive dialysis sessions was 6.1% +/- 0.6%. Changes in blood flow were the main determinant of variations in K(ID)t/V (P < 0.05). During treatment, ionic dialysance decreased by 12 +/- 13 ml/min (P < 0.001). The decline in blood volume was the major determinant of the intra-dialytic change in ionic dialysance (P < 0.05). CONCLUSION: The use of V(IOD) and V(UKM) results in better agreement between eKt/V and K(ID)t/V compared with anthropometric formulae. K(ID)t/V was comparable with eKt/V and thus lower than expected for a single-pool method. V(IOD) and V(UKM), should be assessed at least monthly. K(ID)t/V varies widely between consecutive dialysis sessions, mainly due to differences in blood flow. During treatment, ionic dialysance decreases, which is related to the relative decline in blood volume. |
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Authors:
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Karin Moret; Charles H Beerenhout; A Warmold L van den Wall Bake; Paul G Gerlag; Frank M van der Sande; Karel M Leunissen; Jeroen P Kooman |
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Publication Detail:
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Type: Journal Article Date: 2007-06-05 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 22 ISSN: 0931-0509 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-07-26 Completed Date: 2007-11-07 Revised Date: 2008-02-28 |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 2276-82 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Máxima Medical Centre, Veldhoven, The Netherlands. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Female Glomerular Filtration Rate Humans Ions / chemistry* Kidney / metabolism, physiology Kinetics Male Models, Statistical Models, Theoretical Reproducibility of Results Time Factors Urea / chemistry |
| Chemical | |
Reg. No./Substance:
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0/Ions; 57-13-6/Urea |
| Comments/Corrections | |
Erratum In:
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Nephrol Dial Transplant. 2007 Dec;22(12):3692 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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