Dialysis Adequacy and Prescription Flashcards
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What does the term 'Kt/V' measure in hemodialysis adequacy?
Answer: Dose of dialysis delivered, representing urea clearance relative to urea volume of distribution
Kt/V is a dimensionless index of dialysis adequacy where K = dialyzer clearance, t = treatment time, and V = volume of distribution of urea.
What is the minimum single-pool Kt/V (spKt/V) recommended by KDOQI for thrice-weekly hemodialysis?
Answer: 1.2
KDOQI guidelines recommend a minimum spKt/V of 1.2 per session for patients on thrice-weekly hemodialysis.
URR (urea reduction ratio) is calculated as:
Answer: (Pre-BUN − Post-BUN) ÷ Pre-BUN × 100
URR = (Pre-BUN − Post-BUN) ÷ Pre-BUN × 100, expressing the percentage reduction in blood urea nitrogen during a dialysis session.
A minimum URR of what percentage is recommended for adequate hemodialysis?
Answer: 65%
A URR of at least 65% is the recommended minimum for adequate dialysis, correlating with a Kt/V of approximately 1.2.
Which blood sample timing is critical for accurate Kt/V calculation?
Answer: Post-dialysis sample drawn immediately after stopping the blood pump with a slow-flow technique
The post-dialysis BUN sample must be drawn at low blood flow (approximately 50–100 mL/min) immediately after stopping to avoid cardiopulmonary recirculation affecting results.
Increasing which treatment parameter is the most effective way to improve Kt/V in a hemodialysis patient?
Answer: Treatment time
Extending treatment time is the most effective single intervention for improving Kt/V because it directly increases the 't' component.