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Open Access 01-01-2019 | Educational Review

Assessment of dialysis adequacy: beyond urea kinetic measurements

Author: Lesley Rees

Published in: Pediatric Nephrology | Issue 1/2019

Abstract

Adequacy of dialysis is a term that has been used for many years based on measurement of small solute clearance using urea and creatinine. This has been shown in some but not all studies in adults to correlate with survival. However, small solute clearance is just one minor part of the effectiveness of dialysis and in fact ‘optimum’ dialysis, rather than ‘adequate’ dialysis is what most paediatric nephrologists would want for their patients. Additional ways to assess the success of dialysis in children would include dialysis access complications and longevity, preservation of residual kidney function, body composition, biochemical and haematological control, nutrition and growth, discomfort during the dialysis process and psychosocial adjustment including hospitalisation and school attendance. These criteria need to be balanced against a dialysis programme that has the least possible adverse effects on quality of life.

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Title: Assessment of dialysis adequacy: beyond urea kinetic measurements
Author: Lesley Rees
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 1/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-3914-6

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Assessment of dialysis adequacy: beyond urea kinetic measurements

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