The optimal duration of treatment and Kt/V

Patients generally see the time spent in dialysis as wasted time, which they could spend with their families, at work, and generally getting on with their lives.
This might appear to be true in the short term, but is definitely not so in the long term since it affects life expectancy.
Over a period of 24 hours the kidneys purify the plasma volume more than 60 times, producing over 180 litres of pre-urine which, after tubular reabsorption, is reduced on average to 1.5 litres of actual urine.
Time is an important factor in calculating urea fractional clearance: Kt/V is the expression most widely used for prescribing and calculating the efficiency of dialysis treatment performed.
The European Best Practice Guidelines fixed the target of Kt/V at higher than 1.2 for 80% of treated patients and we are proud to say that in the network of Fresenius Medical Care centres we achieve well above this target. Many factors may affect the "actual" duration of dialysis treatment: the appearance of clinical symptoms during treatment, organisational aspects or a lack of scientific knowledge and awareness.
Nowadays, technology has provided doctors and nurses with an instrument capable of measuring urea clearance during every dialysis session, giving a direct measurement of the dose of purifying treatment actually administered, and the ability to check the weekly mean value for every individual patient. OCM® (Online Clearance Monitor) is the device we are using and is integrated into most of our dialysis machines.
Systematic use of this instrument allows the actual duration of dialysis to be correlated, not just to the number of treatment hours but, above all, to the target Kt/V to be achieved.
The fact that the patient can see the countdown of the time needed to reach the targeted Kt/V allows him to become more involved, with a better understanding of how he is passing his time and for what purpose.


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