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dc.contributor.authorEl-Kateb, Sally
dc.contributor.authorSridharan, Sivakumar
dc.contributor.authorFarrington, Ken
dc.contributor.authorFan, Stanley
dc.contributor.authorDavenport, Andrew
dc.date.accessioned2019-02-11T11:45:02Z
dc.date.available2019-02-11T11:45:02Z
dc.date.issued2016-12-31
dc.identifier.citationEl-Kateb , S , Sridharan , S , Farrington , K , Fan , S & Davenport , A 2016 , ' A single weekly Kt/Vurea target for peritoneal dialysis patients does not provide an equal dialysis dose for all ' , Kidney international , vol. 90 , no. 6 , pp. 1342-1347 . https://doi.org/10.1016/j.kint.2016.07.027
dc.identifier.issn0085-2538
dc.identifier.otherPURE: 13324019
dc.identifier.otherPURE UUID: b8072f46-6746-488b-8d65-27f79059f43e
dc.identifier.otherPubMed: 27653839
dc.identifier.otherScopus: 84994759965
dc.identifier.urihttp://hdl.handle.net/2299/21051
dc.descriptionCopyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
dc.description.abstractDialysis adequacy is traditionally based on urea clearance, adjusted for total body volume (Kt/Vurea), and clinical guidelines recommend a Kt/Vurea target for peritoneal dialysis. We wished to determine whether adjusting dialysis dose by resting and total energy expenditure would alter the delivered dialysis dose. The resting and total energy expenditures were determined by equations based on doubly labeled isotopic water studies and adjusted Kturea for resting energy expenditure and total energy expenditure in 148 peritoneal dialysis patients (mean age, 60.6 years; 97 male [65.5%]; 54 diabetic [36.5%]). The mean resting energy expenditure was 1534 kcal/d, and the total energy expenditure was 1974 kcal/day. Using a weekly target Kt/V of 1.7, Kt was calculated using V measured by bioimpedance and the significantly associated (r = 0.67) Watson equation for total body water. Adjusting Kt for resting energy expenditure showed a reduced delivered dialysis dose (ml/kcal per day) for women versus men (5.5 vs. 6.2), age under versus over 65 years (5.6 vs. 6.4), weight <65 versus >80 kg (5.8 vs. 6.1), low versus high comorbidity (5.9 vs. 6.2), all of which were significant. Adjusting for the total energy expenditure showed significantly reduced dosing for those employed versus not employed (4.3 vs. 4.8), a low versus high frailty score (4.5 vs. 5.0) and nondiabetic versus diabetic (4.6 vs. 4.9). Thus, the current paradigm for a single target Kt/Vurea for all peritoneal dialysis patients does not take into account energy expenditure and metabolic rate and may lead to lowered dialysis delivery for the younger, more active female patient.en
dc.format.extent6
dc.language.isoeng
dc.relation.ispartofKidney international
dc.rightsEmbargoed
dc.subjectAdult
dc.subjectAged
dc.subjectEnergy Metabolism
dc.subjectFemale
dc.subjectHumans
dc.subjectKidney Failure, Chronic
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPeritoneal Dialysis
dc.subjectJournal Article
dc.titleA single weekly Kt/Vurea target for peritoneal dialysis patients does not provide an equal dialysis dose for allen
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.contributor.institutionSchool of Life and Medical Sciences
dc.description.statusPeer reviewed
dc.date.embargoedUntil2017-11-21
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Accepted Version
dcterms.dateAccepted2016-12-31
rioxxterms.versionAM
rioxxterms.versionAM
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1016/j.kint.2016.07.027
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
rioxxterms.licenseref.startdate2017-11-21
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.date.embargo2017-11-21
herts.rights.accesstypeEmbargoed


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