Chapter 7, Problem 11LO

DaVita Dietitian Reference Manual Module 7 - Adequacy of Hemodialysis REVIEW QUESTIONS True False 1. 27 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Urea Reduction Ratio is a more accurate measurement of dialysis adequacy than Urea Kinetic Modeling. A fistula is the preferred type of vascular access. In the formula Kt/V, the V represents volume of total body water in which urea is distributed. In the formula Kt/V, time is measured in 15-minute increments, so 220 minutes would be rounded off to the nearest quarter hour. The DaVita minimum goal for adequacy is a spKt/V≥ 1.0. A measured height and accurate dry weight are required to obtain an accurate Kt/V result. A very low post BUN result usually means the patient is not eating enough protein. KRU is a measure of residual urea clearance by the patient's kidney, requiring a 24-hour urine collection. The Kt/V Delivered (single pool) is the value used for determining adequacy and comparing outcomes in DaVita facilities. Catheters are…

DaVita Dietitian Reference Manual Module 7 - Adequacy of Hemodialysis Case 3 Beverly's monthly adequacy of dialysis results came back lower than usual. Her Kt/V is 1.13. Flow sheet data reveals the following: Prescribed BFR 400, patient ran BFR 325 during treatment Blood pressure dropped to 72/58 during treatment, so UFR was turned off. Dry weight 65 kg, pre dialysis weight 69 kg, post dialysis weight 66.5 kg 1. What are DaVita's goals for Kt/V? 2. What is your impression of why the Kt/V is low? 3. What additional information would help in determining why Beverly's adequacy results were below goal?

DaVita Dietitian Reference Manual Module 7-Adequacy of Hemodialysis DISCUSSION QUESTIONS Define the following abbreviations: • UKM • URR . . • Kt/V What are the minimum DaVita outcome goals for Kt/V and URR? How is the DaVita Quality Index calculated for Kt/V? Discuss effect of adequacy on: ⚫ Phosphorus . ⚫ Potassium • Hemoglobin • Appetite, intake and weight ⚫ Albumin . How is residual renal function measured? What term is used for residual clearance of urea? What are advantages and disadvantages of each dialysis access? Which dialyzes the least efficiently and why?