Renal Data from the Arab World: Assessment of adequacy of hemodialysis dose at a Palestinian hospital

Adequacy of hemodialysis improves patient survival,quality of life and biochemical outcomes and minimizes disease complications and hospitalizations. This study was an observational cross-sectional study that was conducted in July 2012. Blood tests,weight and blood pressure were measured before and after hemodialysis. Single-pool Kt/V and urea reduction ratio (URR) were calculated. The targets based on the National Kidney Foundation Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines were Kt/V ≥ 1.2 and URR ≥ 65%. Of the 64 patients,41 (64.1%) were males. The mean age of the patients was 58.13 ± 17.2 years. The mean body mass index (BMI) was 25.04 ± 5.01 kg/m 2 . The mean Kt/V and URR were 1.06 ± 0.05 and 54.4 ± 19.3,respectively. There was no significant difference between men and women (1.06 ± 0.47 versus 1.04 ± 0.55,P = 0.863) and (54.7 ± 19.59 versus 53.81 ± 19.17,P = 0.296). Only 25 (39.1%) patients achieved the Kt/V goal and only 22 (34.4%) had target URR,and there was no significant association between hemodialysis adequacy and any of the variables such as sex,age,presence of chronic diseases or BMI. Serum potassium levels post-dialysis were significantly lower in patients who reached the target Kt/V (mean = 3.44 ± 0.48 versus 3.88 ± 0.48,P = 0.001). Most patients were inadequately dialyzed and a large percentage of the patients did not attain the targets. Attempts to achieve the desired goals are necessary. It is important to calculate Kt/V or URR and individualize the dialysis doses for each patient.