MP520DIALYSIS DOSE COMPARISON BY REAL-TIME KT/V THROUGH ULTRAVIOLET ABSORBANCE IN SPENT DIALYSATE, SINGLE POOL DAUGIRDAS II AND KT/BSA, ACCORDING SEX AND AGE

Abstract

INTRODUCTION AND AIMS: Individuals of lower weight and higher relative metabolic rate receive lower dialysis dose with the use of KtV urea. KtV On Line through ultraviolet absorbance in spent dialysate (KtVOL) avoids inaccuracies associated with the estimation of urea volume distribution (V). Impact of age is not known. The study aims to compare KtVOL with KtV urea Daugirdas II and KtBSA according sex and age. METHODS: Urea kinetics to calculate KTV single pool Daugirdas II of 47 adult patients for at least 3 months in Hemodialysis. Determination of dry weight by Dry- Weight Reduction in Hypertensive Hemodialysis Patients (DRIP). A Randomized Controlled Trial study methodology (Hypertension. 2009;53:500-507). Clinical and laboratory data collected in the month following the determination of dry weight. V and BSA values obtained by Watson and Haycock formulas. VBSA ratio considered as conversion factor from KtV to KtBSA. KtVOL in the day of the kinetics on B BRAUN DIALOG machines. Statistics by IBM SPSS Statistics 20.0. RESULTS: Regarding clinical and laboratory characteristics (age, dry weight, height, KtV, KtVOL, BSA, Kt, V, KtBSA, VBSA, hemoglobin, albumin, DM and race), dry weight (75,69 ± 14,81 vs 64,75 ± 9,20 P = 0,010), height (1,69 ± 0,08 vs 1,58 ± 0,10 P = 0,000), V (34,67 ± 4,21 vs 30,82 ± 3,08 P = 0,002), BSA (1,89 ± 0,22 vs 1,70 ± 0,16 P = 0,03), Kt (41,61 ± 5,05 vs 36,98 ± 3,70 P = 0,002), KtBSA (21,95 ± 0,16 vs 21,74 ± 0,17 P = 0,000) and VBSA (18,29 ± 0,16 vs 18,12 ± 0,17 P = 0,000), presented significant differences between males and females (Student t test). Age (56,74 ± 9,65 vs 72,45 ± 6,52 P = 0,000) and height (1,68 ± 0,10 vs 1,62 ± 0,95 P = 0,030) presented significant differences between group I (< 65 years) and group II (≥ 65 years) (Student t test). Pearson correlation for the total group between KtVOL and KtV was r = 0,452, P = 0,001, and between KtVOL and KtBSA was r = -0,462, P = 0,001. Pearson correlation was only significant for males (FIGURE 1) and group I (FIGURE 2). KtVOL and KtV were: 1,35 ± 0,24 and 1,24 ± 0,21, P = 0,004; 1,32 ± 0,21 and 1,20 ± 0,23, P = 0,008; 1,40 ± 0,30 and 1,32 ± 0,15, P = 0,218; 1,31 ± 0,27 and 1,23 ± 0,23, P = 0,096 and 1,39 ± 0,20 and 1,26 ± 0,20, P = 0,011, among total group, men, women, group I and II, respectively (Student t test). VBSA ratios among men and women were respectively 18 ± 0,13 and 18,12 ± 0,15, P = 0,000; VBSA ratios among groups I and II were respectively 18,28 ± 0,15 and 18,18 ± 0,16, P = 0,000 (Student t test). CONCLUSIONS: Men and individuals ≥ 65 years have significant positive correlation between KtVOL x KTV and significant negative correlation between KtVOL x KtBSA. KtVOL indicates higher dialysis dose for men and individuals ≥ 65 years compared to KtV. VBSA ratio is significantly higher for men than women and for individuals < 65 years than older. KtVOL allows recognition of real-time dialysis urea kinetics regardless of sex and age. (Figure Presented).