1998 Volume 31 Issue 10 Pages 1317-1321
The 1983 NCDS defined adequacy of dialysis by Kt/V and PCR. The 1989 international syposium on ESRD morbidity and mortality reported that US mortality was higher than that in Europe or Japan. Because of these 2 reports, we decided to check and compare their data with our own data and tried to find a method of hypothetically assessing the adequacy of dialysis by Kt/V and PCR values. Daugirdas' and Gotch's formulas used for calculation of Kt/V and PCR. Data analysis was based on 243 patients (pts.), who were divided into 9 groups (3×3 table) by 3 different ranges of Kt/V and PCR.
TACurea of groups 5, 6, 7, 8, 9 were all under 50mg/dl which was the NCDS recommended value, while groups 7 and 8, presently considered to be receiving overdialysis, may be redefined as adequate in the future. Only 61 pts. (25.1%) belonged to group 5 presently considered to be the adequate dialysis domain, while 126 pts (51.8%) were in groups 7 and 8.
Therefore, we subdivided groups 7, 8 and 9 (namely high-dose-dialysis group; 140 pts.) into 4 groups by the Kt/V value only, at levels of 1.6-2.0, 2.0-2.5, 2.5-3.0 and over 3.0 for groups a, b, c and d, respectively. There was no significant difference in mean age or years on dialysis among the 4 groups. Significant differences were found in the values for TACurea, β2-MG, Ca and P product between groups a and b only, but not among the other groups. We concluded that the clinically critical point of dialysis dose calculated by Kt/V might be 2.0. Kt/V over 2.0 may be the true ideal dialysis dose for most hemodialysis patients.
