An analysis of body weight and hemodialysis adequacy based on the urea reduction ratio... including commentary by Brunt H with author response
NLM Title Abbreviation
The purpose of this study was to evaluate inadequate hemodialysis risk in patients with body weights in the upper quartile of a sample distribution using the urea reduction ratio (URR). Using a case-control design and a simple (n = 315) of hemodialysis (HD) patients, postdialysis weights were divided into quartiles based with a cut-off value at the upper quartile, which was equal to >/= 81 kilograms (kg). The dichotomous outcome, URR >/= 65% and URR /= 81 kg group were given more dialysis session time in minutes and used higher efficiency dialyzers as indicated by the coefficient of ultrafiltration (KUf), yet were more likely to have URRs /= 81 kg group were given more dialysis session time in minutes and used higher efficiency dialyzers as indicated by the coefficient of ultrafiltration (KUf), yet were more likely to have URRs 81 kg experienced an increased risk of inadequate dialysis when compared to all others (OR 4.02, 95% CI [confidence interval] 2.217-7.29). A postdialysis weight >/= 81 kg increased the risk of inadequate dialysis for patients in this sample. This effect was confounded by a dialysis time x weight interaction term. Also, women were found to have a lower inadequate dialysis risk compared to men after adjusting for weight classification. We, therefore, conclude that patients who weigh >/= 81 kg may experience inadequate dialysis despite longer, more efficient dialysis sessions. Longer dialysis sessions may benefit some patients, but the effect in larger patients may not be a uniform response.
Hemodialysis -- Evaluation, Urea, Body Weight, Treatment Outcomes -- Evaluation, Blood Urea Nitrogen, Blood Specimen Collection, Odds Ratio, Case Control Studies, Random Sample, Retrospective Design, Logistic Regression, Analysis of Variance, Analysis of Covariance, Human
Published Article/Book Citation
ANNA Journal, 26:4 (1999) pp.391-401.