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Review
. 2019 Jan;34(1):61-69.
doi: 10.1007/s00467-018-3914-6. Epub 2018 Mar 26.

Assessment of dialysis adequacy: beyond urea kinetic measurements

Lesley Rees  1
Affiliations
Review

Assessment of dialysis adequacy: beyond urea kinetic measurements

Lesley Rees. Pediatr Nephrol. 2019 Jan.

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.

Keywords: Adequacy; Dialysis; Optimum dialysis.

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Conflict of interest statement

The author declares that he has no conflict of interest.

Figures

Fig. 1
Fig. 1
Ensuring optimal dialysis: access is crucial
Fig. 2
Fig. 2
The malnutrition, inflammation, arteriosclerosis syndrome (MIA complex)
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