By John T. Daugirdas MD, Peter G. Blake MB FRCPC FRCPI, Todd S. Ing MB FRCP
ISBN-10: 0781752531
ISBN-13: 9780781752534
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Additional info for Handbook of Dialysis
Sample text
Indices of urea removal • Urea reduction ratio (URR). The current primary measure of dialysis adequacy is the treatment-related urea reduction ratio, or URR. This is computed as follows: Assume that predialysis SUN is 60 mg/dL and postdialysis SUN is 18 mg/dL. 70. By convention, URR often is expressed as a percentage, so the value of the URR in this example would be 70%. 4 mmol/L. 70. By convention, URR often is expressed as a percentage, so the value of the URR in this example would be 70%. • Definition of spKt/V (single-pool Kt/V).
Urea nitrogen removed can then be estimated as liters of plasma cleared à Predicted intradialytic SUN. , 238 mL per minute à 240 minutes): How much urea nitrogen should be removed using the single-pool model? 55 g/L = 32 g. 14 mol. 14 mol) should have been recovered. Why the discrepancy? One reason for the error in computations is due to urea inbound. Due to urea sequestration during dialysis, the actual time-averaged intradialytic SUN was substantially lower than the predicted value of 55 mg/dL.
In the aorta, the cleared blood is partitioned; some of it gets routed to the nonaccess arteries that lead it to the tissues to pick up more urea, but a fraction goes directly back through the access to the dialyzer without having traversed a peripheral capillary bed. When a dialyzer is fed from a venous access, cardiopulmonary recirculation cannot occur. Although an AV urea gradient is still present, all of the blood leaving the dialyzer must go through the peripheral capillary bed before it sees the dialyzer again.
Handbook of Dialysis by John T. Daugirdas MD, Peter G. Blake MB FRCPC FRCPI, Todd S. Ing MB FRCP
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