Adequacy of dialysis

Abstract

Adequate dialysis is not easily defined. The concept that there is a relationship between dialysis dose and survival is gradually gaining acceptance. Nutritional status and possibly the type of dialyzer membrane used also influence survival in hemodialysis patients. The roles of physicians, patient care staff, technicians, nutritionists, and social workers in assuring adequacy can be clearly delineated in practice. Until recently, health status and quality of life evaluations have received less attention than clinical and laboratory parameters of adequacy. Instruments used to assess quality of life must be further developed and integrated with survival and morbidity data to improve the level of care provided for dialysis patients. The tools are available to enhance adequacy; they need to be utilized.