Correlation between Dt/V derived from ionic dialysance and blood-driven Kt/V of urea in African-American hemodialysis patients, based on body weight and ultrafiltration volume

Wihib Gebregeorgis, Zeenat Yousuf Bhat, Nishigandha Pradhan, Stephen D. Migdal, Lakshminarayanan Nandagopal, Reddy Singasani, Tehmina Mushtaq, Ronald Thomas, Yahya M.Osman Malik

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: The Dt/V obtained by using ionic dialysance (D) as a surrogate for urea clearance (K) is a well-validated adjunct measure of hemodialysis adequacy, with a variable level of correlation with urea-based Kt/V. However, this correlation has not been examined based on patients' body size and ultrafiltration (UF) volume during the dialysis session. Methods: Simultaneous evaluations of online Dt/V and single-pool variable-volume urea Kt/Vwere made. Patientswere categorized into three subgroups based on their weight (<60, 60-80 and≥80kg), bodymass index (<25, 25-30 and>30kg/m2) andUF volume (<1.5, 1.5-3 and>3L). The correlation between Dt/V and Kt/Vwas evaluated for the entire cohort per dialysis session in each subgroup. Results: Mean Kt/V was greater than themean Dt/V (1.72 versus 1.50, P<0.001), with an overall correlation r value of 0.602. This correlation was stronger in themediumweight group versus lower and higher weights. The correlation between Dt/V and Kt/V was inversely related to the UF volume (r=0.698, 0.621 and 0.558 for those with UF volume of<1.5, 1.5-3.0 and>3 L, respectively). A total of 99.3% of patients with Dt/V of>1.2 also had Kt/V>1.2 and 9.5% of those with Dt/V<1.2 had their Kt/V<1.2. Conclusions: There is a moderate degree of correlation between Dt/V and Kt/V in African-American hemodialysis patients, which is impacted by body size and UF volume. A Dt/V of>1.2 strongly predicts adequate dialysis as defined by Kt/V of>1.2.

Original languageEnglish
Pages (from-to)734-741
Number of pages8
JournalClinical Kidney Journal
Volume11
Issue number5
DOIs
StatePublished - Oct 1 2018

Keywords

  • African American
  • Dt/V
  • Kt/V
  • adequacy
  • hemodialysis

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