Dialysis adequacy

In nephrology, dialysis adequacy is the measurement of renal dialysis for the purpose of determining dialysis treatment regime and to better understand the pathophysiology of renal dialysis. It is an area of considerable controversy in nephrology.

In the US, the dominant way of measuring dialysis adequacy in Kt/V and based on the clearance of urea.

Urea

Comparing normal to ERSD

The normal clearance of urea is approximately 100 ml/min. A patient getting a conventional hemodialysis treatment, without remaining residual function, has a urea clearance of 10-15 ml/min.

beta-2 Microglobulin

Physiology of the kidneys and acid-base physiology

Renal function

Secretion	clearance Pharmacokinetics Clearance of medications Urine flow rate

Reabsorption	Solvent drag sodium chloride urea glucose oligopeptides protein

Renal function	Glomerular filtration rate Creatinine clearance Renal clearance ratio Urea reduction ratio Kt/V Standardized Kt/V Measures of dialysis Hemodialysis product PAH clearance (Effective renal plasma flow Extraction ratio)

Filtration	Renal blood flow Ultrafiltration Countercurrent exchange Filtration fraction

Hormones

Acid-base balance

Body water: Intracellular fluid/Cytosol

Buffering

Other

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