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Urea kinetic modelling: a measure of dialysis adequacy

2001; SAGE Publishing; Volume: 38; Issue: 1 Linguagem: Inglês

10.1258/0004563011900245

1758-1001

Helena Kemp, AP Parnham, Charles Tomson,

Electrolyte and hormonal disorders

Great advances have been made since the ®rst therapeutically successful dialysis was described in 1943. Dialysis was at ®rst a prolonged, expensive and labour-intensive procedure which was only used to prevent death from hyperkalaemia or uid overload, being limited to young patients with acute renal failure while their own kidneys recovered. Later, this indication was extended to patients destined for urgent renal transplantation. With advances in technology, dialysis has now become cheaper and less onerous: more than 95% of the dialyses performed in the UK are for chronic renal failure on a routine outpatient basis; only 25% of patients on dialysis are waiting for a transplant. As there is a shortage of cadaveric donors only one-third of those on the list will receive a kidney transplant. This means that the majority of such patients will spend the rest of their lives on dialysis. It is therefore no longer suf®cient to keep the electrolytes within safe levels and the patient out of pulmonary oedema. The aim must be to keep the patients healthy and mobile, and so prolong their survival. Thus the concept of dialysis adequacy has developed over the last 20 years.