Kt/V: A Magical Formula for Dialysis Adequacy: A Critical Review

Abstract

: Long-term prognosis of chronic hemodialysis patients is affected by dialysis adequacy; thus, evaluation of dialysis adequacy plays a key role in assessment of healthcare system in all countries. Currently, urea reduction ratio (URR) and Kt/V are applied to evaluate dialysis adequacy; however, due to the inconsistency between their results and patient outcome, their application has been questioned. Herein, we aimed at broadly reviewing the shortcomings of Kt/V index for appraisal of dialysis adequacy. For this purpose, we searched MEDLINE, EMBASE, Science direct, Cochrane Library, Scopus, and Google Scholar for relevant literature without any time or language limitations from May 2016 to February 2017. The applied keywords were “dialysis adequacy” OR “dialysis sufficiency” OR “dialysis competence” OR “dialysis efficiency”. We summarized all the studies questioning the success of Kt/V index in appraisal of dialysis adequacy to investigate whether Kt/V is still an appropriate index for evaluation of adequacy of different types of dialysis. The results of this study revealed that Kt/V is not the best criterion and one cannot be assured of dialysis adequacy solely based on this criterion.