Urea Kinetic Modelling by Partial Dialysate Collection

Abstract

Conventional urea kinetic modelling (UKM) has several drawbacks, in particular the complexity of the required calculations and the need for accurate values of parameters which are difficult to measure, such as dialyzer clearance and blood flow. An alternative method of UKM is proposed based on collecting a small fraction of spent dialysate flow for 3 consecutive dialyses. Application of a urea mass balance to the 7 day period permits neglecting changes in body urea stores. Thus no blood sampling is required for most patients. The required calculations are simple and straightforward. The partial dialysate collection (PDC) method was compared to conventional UKM in a 3 patient, 15 week study. Protein catabolic rate (PCR) from PDC was a smooth curve and consistent with dietary estimation for each patient. Conventional UKM gave variable PCR results which were 17-27% higher on average. This discrepancy was attributed to overestimation of dialyzer clearance. PDC was concluded to be more convenient and accurate than conventional UKM and therefore ideal for routine clinical use.