Should Chronic Kidney Disease Patients & Doctors Stop Considering Kt/V A Marker Of Dialysis Success?

Many Chronic Kidney Disease patients who are conducting Dialysis mention, "I feel so bad after Dialysis because I feel nauseous and tired." However in the long-run, patients should start to feel better if they receive a good Dialysis Cleaning. While the ratio of urea clearance (K) multiplied by time on Dialysis (t) divided by the volume of water in a patient's body is a widely accepted measure to determine Dialysis Cleaning Adequacy, Researchers are now contemplating retiring the Kt/V marker due to inefficiencies.

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If you currently conduct Dialysis then you have heard your Dietitians and Nephrologists say the word Kt/V. Perhaps you have used it yourself to determine if your Dialysis Treatment rendered above the 1.2 average or greater than the 1.4 optimal goal. Still according to Researchers, Kt/V is "too simple a concept for the complexities of uremia (harmful toxic compound build-up) for today’s Dialysis." 

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Developed in the 1980's when Dialysis was short and "applied thrice (three times) weekly with small pore cellulosic dialyzers." Hence, the Kt/V metric does not account for other harmful toxins which may lead to morbidity (a further diseased state) or mortality (death) in those who conduct Dialysis. Studies have supported that there was no benefit to increased Kt/V and the formula did not account for "metabolic (by-products of your metabolism) or intestinal (bacteria in intestine) toxins. 

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Basically, Researchers at the Ghent University Hospital suggested that the Kt/V measure may be used just as a "baseline parameter of Dialysis adequacy," but should not be too heavily relied upon since it is "too simple a concept" for modern day Dialysis.

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Beyond Kt/V Chronic Kidney Disease patients who conduct Dialysis may not immediately feel the harmful effects of waste materials building up in their bodies, but some symptoms can help you figure out if you are receiving inadequate Dialysis:

Severe and continual weakness and fatigue

  • Loss of appetite
  • Yellow coloration of skin
  • Nausea or vomiting
  • Bad taste in your mouth
  • Loss of weight
  • Disturbed sleep
  • Itching
  • Prolonged bleeding

To maintain or improve Dialysis cleaning outcomes patients should:

  • Be on time for their Dialysis sessions
  • Make sure they stay till the end of the treatment session.
  • Don't settle for lesser treatment time in case the staff wants to leave.
  • Ensure they make up for time lost during bathroom trips or machine breakdowns.
  • Follow the fluid intake limits between sessions.

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References:

"How Does My Doctor Know If Dialysis Is Working?"Http://www.davita.com/. DaVita HealthCare Partners Inc.

"Once upon a Time in Dialysis: The Last Days of Kt/V?" Nature.com. Nature Publishing Group.

"Should Kt/V Be Retired as a Marker of Dialysis Adequacy?"Http://www.nephrologynews.com. Nephrology News and Issues.