Objectives:
@EN to assess adequacy of dialysis according to frequency of hemodialysis per week in patients with end stage renal diseases, we calculated the dose of dialysis with urea kinetic modeling and checked serum levels of several biochemical
nutritional
parameters. And then, we compared above values.
@ES methods and materials:
@EN We selected 40 patients undergoing maintenance hemodialysis over 3 months from January 1993 to December 1994. We divided them 2 groups such as group 1, those who had taken hemodialysis three times(23) a week, and group 2, those who had taken
hemodialysis 2 times(17) a week. Monthly, we checked pre-hemodialysis serum levels of biochemical nutritional parameters such as cholesterol, BUN, creatinine, potassium, levels of biochemical nutritional parameters such as cholesterol, BUN,
creatinine,
potassium, phosphorus and albumin, measured their arterial pressures at blood sampling day, and calculated Kt/V urea, weekly Kt/V urea, NPCR(normalized protein catabolic rate) and URR(urea reduction ratio) with urea kinetic modeling during study
periods. After then we calculated their mean values.
@ES Results:
@EN 1) Clinical characteristics
Mean ages were 47.82±2.77 years in group 2. There was no statistical difference in mean age between two groups. Mean dialyzer blood flow rates were 227.10±4..40 mL/min in group 1 and 239.78±2.70 mL/min in group 2, and total minutes per
eessoins
236.03±3.33 min in group 1 and 285.26±3.52 min in group 2. There were statistical differences in level of mean dialyzer blood flow rate and total minutes per sessoin between two groups(p<0.01).
2) Serum biochemical nutritional parameters.
In group 1 and group 2, mean values of serum concentration of cholesterol were 150.43±9.13 mg/dL and 146.62±7.73 mg/dL, those of BUN 72.10±3.85 mg/dL and 75.51±3.09 mg/dL, those of creatinine 10.02±0.60 mg/dL and 11.36±0.76 mg/dL, those of
potassium 5.33±0.16 mEq/L and 5.50±0.14 mEq/L, those of phosphorus 4.81±0.24 mg/dL and 5.50±0.32 mg/dL, and those of albumin 3.96±0.11 g/dL and 4.11±0.05 g/dL, respectively. these was no statistical difference in mean pre-hemodialysis serum
concentrations of cholesterol, BUN, creatinine, potassium, phosphours and albumin between two groups. Serum level of creatinine showed positive correlation with that of albumin(r=0.414, p<0.01) in study patients.
3) urea kinetic modeling parameters
In group 1 and group 2, mean values of Kt/V urea were 1.09±0.05 and 1.47±0.05, those of weekly Kt/V urea 3.25±0.15 and 2.94±0.09, and those of URR 0.60±0.01 and 0.71±0.02, respectively. there were statistical differences in mean values of
UKM
parameters such as Kt/V urea, weekly Kt/V urea and URR between two groups(p<0.01). mean value of NPCR was 0.94±0.04 g/kg/day in group 1 and 0.85±0.03 g/kg/day in group 2. There was statistical difference in mean value of NPCR between two
group(p<0.05). supposed no residual renal clearance, NPCR showed positive correlation with weekly-Kt/V urea(r=0.413, p<0.01).
4) Mean arterial pressure.
Mean arterial pressures were 109.48±3.77 mmHg in group 1 and 111.61±1.99 mmHg in group 2. There was no statistical difference between two groups.
@ES Conclusion:
@EN In assessment of adequacy of hemodialysis according to the frequency per week, we could conclude that no difference in serum biochemical nutritional parameters including albumin between two groups, despite of less weekly-K/V urea in group 2
than
that in group 1, was due to faster blood flow and longer total minutes per session during hemodialysis(i.e., increase in Kt/V urea and urea reduction ratio) in group 2. So, we can overcome the difference in weekly-Kt/V urea even in those who take
hemodialysis two times a week, if we increase the level of Kt/V urea or urea reduction ratio during hemodialysis.
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