A Simplified Approach to Understanding Urea Kinetics in Peritoneal Dialysis and Hemodialysis

2006 ◽  
pp. 20-27
Author(s):  
Madhukar Misra ◽  
Karl Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Simplified Approach ◽  
Urea Kinetics

The Rationale and Ultimate Limitations of Urea Kinetic Modelling in the Estimation of Nutritional Status

1996 ◽  
Vol 16 (4) ◽  
pp. 347-351 ◽  
Author(s):  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Amino Acid Metabolism ◽  
Acid Metabolism ◽  
Kinetic Modelling ◽  
Nutritional Indices ◽  
Helpful Tool ◽  
Urea Kinetics ◽  
False Sense ◽  
Difficult Issue ◽  
Urea Kinetic Modelling

Objective This paper reviews protein flux and amino acid metabolism and the potential inaccuracies inherent in using urea kinetics as an estimate of these processes, particularly in the patient undergoing peritoneal dialysis. The problems of extrapolating these estimates back to the whole patient are examined, addressing assumptions about neutral nitrogen balance, and the difficult issue of normalizing urea-derived indices to body size. Conclusions Urea kinetics can be a helpful tool for assessing nutritional indices, but there are many caveats and many pitfalls that must be kept in mind to avoid being lulled into a false sense of confidence by the comfort of numbers.

Calculating Standard Kt/V during Hemodialysis Based on Urea Mass Removed

2018 ◽  
Vol 47 (1-3) ◽  
pp. 62-68
Author(s):  
John K. Leypoldt ◽  
Edward F. Vonesh
Keyword(s):  
Peritoneal Dialysis ◽  
Theoretical Consideration ◽  
Compartment Model ◽  
Distribution Volume ◽  
Theoretical Understanding ◽  
Novel Approach ◽  
Urea Kinetics ◽  
Predicted Values ◽  
Urea Distribution Volume ◽  
Urea Reduction Ratio

Background/Aims: We derived a novel equation for calculating weekly urea standard Kt/V (stdKt/V) during hemodialysis (HD) based on urea mass removed, comparable to the approach during peritoneal dialysis. Methods: Theoretical consideration of urea mass balance during HD led to the following equation for stdKt/V, namely, stdKt/V = N × (URR + UFV/V), where N is the number of treatments per week, URR is urea reduction ratio per treatment, UFV is ultrafiltration volume per treatment, and V is postdialysis urea distribution volume. URR required corrections for postdialysis rebound and intradialytic urea generation. We compared the accuracy of this approach with previous equations for stdKt/V by numerical simulations using a 2-compartment model of urea kinetics for thrice-weekly and more frequent HD prescriptions. Results: The proposed equation based on urea mass removed predicted values of stdKt/V that are equivalent to those calculated by previous equations for stdKt/V. Conclusion: This work provides a novel approach for calculating stdKt/V during HD and strengthens the theoretical understanding of stdKt/V.

scholarly journals KAJIAN LITERATUR: PENGARUH TELENURSING TERHADAP KUALITAS HIDUP PASIEN DENGAN PENYAKIT GINJAL KRONIK YANG MENJALANI CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) [LITERATURE REVIEW: THE EFFECT OF TELENURSING ON THE QUALITY OF LIFE OF PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)]

2021 ◽  
Vol 9 (2) ◽  
pp. 169
Author(s):  
Ballsy Cicilia Albertina Pangkey ◽  
Fendy Yesayas ◽  
Fatima Ura Pabane
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Health Services ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Flow Diagram ◽  
Simplified Approach ◽  
Approach Method

<p><em>Chronic Kidney Disease (CKD) is one of the diseases associated with symptoms or disability that requires </em><em>long-term management. One of the interventions that can be done in patients with CKD is Continuous </em><em>Ambulatory Peritoneal Dialysis (CAPD). Self-care for patients with CKD requires optimal services for </em><em>medical, social, mental, and emotional problems. Telenursing can be used as a process of providing </em><em>management, coordination of care, and health services through information technology and </em><em>telecommunications, so that patients’ problem related to treatment can be resolved and the quality of life of </em><em>patients can be improved. The purpose of this study was to determine the effect of telenursing on the quality of </em><em>life of patients with CKD undergoing CAPD. PICOT framework was utilized to find related journals. The data </em><em>sources of this researchwere taken from the e-resources database of National Library of Indonesia, PubMed </em><em>and Google Scholar and then selected using the PRISMA flow diagram to produce nine articles. Each article </em><em>had been described and criticized in the form of a matrix table using a simplified approach method. Three </em><em>themes then emerged from the analysis, namely the quality of life of CKD patients who were running CAPD </em><em>was good, the quality of life of CKD patients who were running CAPD was better than patients who were </em><em>undergoing hemodialysis, and the quality of life of CKD patients who were running CAPD by telenursing had </em><em>increased. Telenursing can facilitate patient access in seeking health services and increase the effectiveness of </em><em>patient time, so that the patient's quality of life can improve.</em><strong><br /><br />BAHASA INDONESIA ABSTRAK: </strong>Penyakit Ginjal Kronik (PGK) merupakan salah satu penyakit yang berkaitan dengan gejala-gejala atau kecacatan yang membutuhkan penatalaksanaan jangka panjang. Salah satu intervensi yang dapat dilakukan pada pasien dengan PGK adalah<span class="Apple-converted-space"> </span><em>Continuous Ambulatory Peritoneal Dialysis (CAPD)</em>. Perawatan diri pada penderita PGK membutuhkan layanan yang optimal terhadap masalah-masalah yang bersifat medis, sosial, mental, dan emosional. Telenursing dapat dijadikan sebagai suatu proses pemberian manajemen, koordinasi asuhan, dan layanan kesehatan melalui teknologi informasi dan telekomunikasi, sehingga masalah-masalah yang ada pada pasien terkait pengobatan dapat teratasi dan kualitas hidup pasien dapat meningkat. Tujuan penelitian ini untuk mengetahui pengaruh telenursing terhadap kualitas hidup pasien dengan PGK yang menjalani CAPD. Dalam strategi mencari jurnal framework yang digunakan adalah PICOT. Sumber data yang digunakan diambil dari database e-resources Perpusnas, PubMed dan Google Scholar kemudian diseleksi dengan menggunakan flow diagram PRISMA sehingga menghasilkan sembilan artikel. Setiap artikel telah dijabarkan dan dikritisi dalam bentuk tabel matriks menggunakan simplified approach method. Hasil penelitian ditemukan tiga tema yaitu kualitas hidup pasien PGK yang menjalankan CAPD baik, kualitas hidup pasien PGK yang menjalankan CAPD lebih baik dibandingkan dengan pasien yang menjalankan hemodialisis, dan kualitas hidup pasien PGK yang menjalankan CAPD dengan telenursing mengalami peningkatan. Telenursing dapat mempermudah akses pasien dalam mencari pelayanan kesehatan dan menambah efektivitas waktu pasien, sehingga kualitas hidup pasien dapat meningkat.</p>

Urea Kinetics and Clinical Features of Long Term Continuous Ambulatory Peritoneal Dialysis Patients

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 180-182 ◽  
Author(s):  
Kazuo Kumano ◽  
Yutaka Takagi ◽  
Shinji Yokota ◽  
Satoru Shimura ◽  
Tadasu Sakai
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Clinical Assessment ◽  
Biochemical Parameters ◽  
Clinical Symptoms ◽  
Close Correlation ◽  
Albumin Concentration ◽  
Assessment Scores ◽  
Urea Kinetics

The purpose of this study was to assess urea kinetic modeling (UKM) as a marker for adequate dialysis in continuous ambulatory peritoneal dialysis (CAPD) patients. UKM was conducted on 19 anuric patients on CAPD for more than 2 years. Serum β2-microglobulin (β2M) was also measured as a marker of large molecular weight substances. Patient clinical conditions were evaluated by the doctors and patients as well. The patients were thus asked to complete a questionnaire on uremic symptoms an d daily activities. A comparison was made in urea kinetics and biochemical parameters based on clinical assessment scores. Patient and doctor scores showed a close correlation (r=0.69) and were correlated to days of hospitalization. The peritonitis rate was significantly higher in the “not doing well” group. No correlation could be found between indexes of UKM or β2M plasma level and clinical assessment scores. A signlficant correlation was noted between serum albumin concentration and doctor scores (r=0.52). It was thus concluded that UKM was not a good indicator of the adequacy of dialysis for CAPD, but serum albumin was. However, clinical symptoms and signs are more important than biochemical parameters for assessing adequacy.

Urea kinetics and other dialysis indices in children undergoing ambulatory peritoneal dialysis

2000 ◽  
Vol 4 (3) ◽  
pp. 225-230
Author(s):  
K. Iitaka ◽  
S. Moriya ◽  
K. Tomonaga ◽  
H. Koshino ◽  
M. Hojo
Keyword(s):  
Peritoneal Dialysis ◽  
Urea Kinetics

scholarly journals Clinical outcome of continuous ambulatory peritoneal dialysis predicted by urea and creatinine kinetics.

1992 ◽  
Vol 2 (9) ◽  
pp. 1430-1435
Author(s):  
J C Brandes ◽  
W F Piering ◽  
J A Beres ◽  
S S Blumenthal ◽  
C Fritsche
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcome ◽  
Creatinine Clearance ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Treatment Time ◽  
Residual Renal Function ◽  
Cross Sectional ◽  
Group I ◽  
Urea Kinetics ◽  
Creatinine Kinetics

The effectiveness of urea kinetics (Kt/V, where K is urea clearance, t is treatment time, and V is the volume of distribution for urea) to assess the adequacy of continuous ambulatory peritoneal dialysis (CAPD) and clinical outcome has not been established prospectively, and cross-sectional clinical studies have been inconclusive. A minimum weekly creatinine clearance of 40 to 50 L is recommended, but the adequacy of this dose is unproven. We introduced a simpler approach to creatinine kinetics in the form of an efficacy number (EN) calculated from data obtained in a standardized 4-h dwell exchange. To determine the most effective model for predicting CAPD adequacy, residual renal function, weekly Kt/V urea, weekly creatinine clearance standardized to body surface area, and EN (liters per gram of creatinine per day) were measured in 18 stable CAPD patients followed prospectively for at least 12 months. Patients were divided into three groups, good (G), intermediate (I), and poor (P), on the basis of uremic symptoms, mortality, hospital days, biochemical indices, and the need for transfer to hemodialysis. When comparing groups G (N = 6) and P (N = 8), weekly Kt/V were 2.3 +/- 0.2 versus 1.5 +/- 0.1 (P less than 0.005), weekly creatinine clearances were 71.5 +/- 8.6 versus 35.1 +/- 1.3 L (P less than 0.001), and EN were 7.4 +/- 0.8 versus 3.6 +/- 0.2 L/g of creatinine/day (P less than 0.005). Creatinine kinetics (weekly clearance and EN) but not urea kinetics could differentiate group I (N = 4) from groups G or P. Both urea and creatinine kinetics predict clinical outcome in CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)

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