Comparison of Kt/V and urea reduction ratio in measuring dialysis adequacy in paediatric haemodialysis in England.
BACKGROUND
The National Kidney Foundation-Dialysis Outcomes Quality Initiative (KDOQI) guidelines and the Renal Association recommend the use of either Kt/V or urea reduction ratio (URR) to measure haemodialysis adequacy.


OBJECTIVES
To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of single pool Kt/V (spKt/V) and URR.


DESIGN
A service evaluation was conducted to establish current practices in measuring dialysis adequacy. A prospective longitudinal study was conducted to compare spKt/V and URR.


PARTICIPANTS
Thirty-two children were recruited consisting of 13 males and 19 females in five paediatric dialysis centres.


RESULTS
Inconsistencies were reported of the method of post-urea sampling with 4 of the 10 centres using the KDOQI recommended sampling method. Five dialysis centres reported using URR and five reported using spKt/V. There were substantial differences between the two measures. Using URR suggested that up to 44% of children did not receive adequate dialysis, whereas measurement by spKt/V suggested no more than 6% of the same dialysis sessions were not adequate.


CONCLUSION
One standard measure should be used to assess dialysis adequacy in paediatric centres in England. KDOQI guidelines were not consistently followed in obtaining a post-urea blood sample and this procedure should be standardised.
['Dunne|Nina|N|', 'Campbell|Malcolm|M|', 'Fitzpatrick|Maggie|M|', 'Callery|Peter|P|']
D000293:Adolescent D001806:Blood Urea Nitrogen D002648:Child D002675:Child, Preschool D004739:England D005260:Female D019983:Guideline Adherence D015312:Hemodialysis Solutions D006436:Hemodialysis Units, Hospital D006801:Humans D007676:Kidney Failure, Chronic D008297:Male D012016:Reference Values D006435:Renal Dialysis D016896:Treatment Outcome
Kt/V Dialysis Adequacy Paediatric URR