Adequacy indices of frequent haemodialysis regimens and conversion of Kt/V in frequent HD schedules onto Kt/V of conventional thrice weekly schedule

Abstract

Assessment of haemodialysis treatment adequacy should answer the question on "how much dialysis is enough". It must define an assessment marker and give also its target values.

In the mid-80ies, the relative dialysis dose Kt/V has been generally accepted as such marker and its target values established by the HEMO study at the turn of the millennium for then the most common schedule of 3 haemodialyses per week. It is also used in the dialysis quality evaluation system induced by the Czech insurance in 2018.

However, that approach is not applicable for dialysis schedules with more than three sessions in a week, often referred to as alternative or frequent and used mainly for home haemodialysis. For that, more universal adequacy markers have been developed, independent of the number of sessions per week.

The article describes those new markers and develops as an alternative to them the method of converting the conventional dialysis dose of a session in the frequent schedule onto a Kt/V of an equivalent schedule of three sessions per week which enables use of well established target values of that regime.