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Kt/V (Dialysis Adequacy)

Input

mg/dL
mg/dL
L
kg
hours

Kt/V

Urea Reduction Ratio

About

Kt/V is the primary measure of hemodialysis adequacy. It quantifies the fractional clearance of urea during a dialysis session, where K = dialyzer clearance, t = time, and V = volume of distribution of urea. The Daugirdas second-generation formula accounts for ultrafiltration and urea generation during dialysis. KDOQI guidelines recommend a minimum single-pool Kt/V of ≥ 1.2 for thrice-weekly hemodialysis.

Formula

Kt/V = −ln(R − 0.008 × t) + (4 − 3.5 × R) × UF/W
R = Post-dialysis BUN / Pre-dialysis BUN
t = dialysis time (hours), UF = ultrafiltration (L), W = post-dialysis weight (kg)
URR (%) = (Pre-BUN − Post-BUN) / Pre-BUN × 100

Interpretation

Kt/VURRInterpretation
≥ 1.4≥ 70%Excellent
1.2 – 1.465–70%Adequate (target)
1.0 – 1.260–65%Borderline
< 1.0< 60%Inadequate

References

  1. Daugirdas JT. Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol. 1993;4(5):1205-1213.
  2. KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update. Am J Kidney Dis. 2015;66(5):884-930.

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Disclaimer

For educational and informational purposes only. Not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional.