Salman T Shall, Rizwanul Haq, Tahir Shafi.
Adequacy of hemodialysis and laboratory parameters in patients at Shaikh Zayed Medical Complex Hemodialysis Center, Lahore.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;17(1):7-12.

Hemodialysis is an established mode of treatment for end stage renal disease (ESRD) patients. Various studies have shown increased morbidity and mortality among ESRD patients who receive inadequate dialysis. We conducted a study to determine adequacy of hemodialysis in terms of urea reduction ratio and Kt/V in our hemodialysis unit. We also calculated and analyzed various clinical and laboratory parameters in these patients to determine frequency of patients who have these values in target range or in range associated with lower mortality. We selected 94 ESRD patients who were on maintenance hemodialysis for at least 3months. To calculate adequacy of dialysis, pre dialysis BUN, pre dialysis weight, post dialysis BUN, post dialysis weight and duration of dialysis were determined. Urea reduction ratio and Kt/V were calculated by using mathematical formulae. Mean Kt/V was found to be 1.12±0.4 and mean URR was 59.7±13.7%. Only 40% and 39.7% of all patients had Kt/V above 1.2 and URR above 65% respectively. Mean arterial blood pressure was adequate in 62.8% patients. Calcium, alkaline phosphatase, phosphate and potassium were found in recommended range in 45.7%, 46.8%, 77.7% and 83% of all patients respectively. Only 19.1% and 72.3% patients had hemoglobin and albumin in adequate range. We recommend that adequacy of hemodialysis should be assessed regularly in ESRD patients and further studies should be conducted to determine various factors responsible for inadequate hemodialysis. We also recommend more intensive management of hypertension, anemia and calcium-phosphate balance in these patients.

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