Table of Contents
Advances in Nephrology
Volume 2016, Article ID 9342853, 8 pages
http://dx.doi.org/10.1155/2016/9342853
Research Article

Association of Continuous-Equivalent Urea Clearances with Death Risk in Intermittent Hemodialysis

1Savonlinna Central Hospital, 57120 Savonlinna, Finland
2School of Health Sciences, University of Tampere, 33014 Tampere, Finland
3School of Medicine, University of Tampere, 33014 Tampere, Finland
4Tampere University Hospital, 33521 Tampere, Finland

Received 19 January 2016; Accepted 30 March 2016

Academic Editor: Deepak Malhotra

Copyright © 2016 Aarne Vartia et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Several reports describe favorable results from frequent hemodialysis, but due to the lack of unequivocal dose measures it is not clear whether the benefits are due to more efficient toxin removal or other factors. Methods. The associations with death risk of six continuous-equivalent urea clearance measures were compared in 57 conventional in-center hemodialysis treatment periods of 51 patients, together 114 patient years. The double pool dose measures were calculated with the Solute-Solver program and separately scaled to urea distribution volume or normalized with body surface area. Results. Mortality associated significantly with equivalent renal urea clearance (EKR) scaled to urea distribution volume () () and with EKR normalized with body surface area (BSA) () but not with -scaled () nor BSA-normalized () standard clearance (stdK). Women had significantly higher normalized protein catabolic rate (nPCR), , and than men but slightly lower BSA-normalized dose measures and lower mortality. Protein catabolic rate and dialysis dose correlated positively with each other and with survival. Conclusions. The prognostically most valid continuous-equivalent clearance in the present material was , calculated from double pool urea generation rate, distribution volume, and time-averaged concentration.