ORIGINAL PC PROGRAM FOR DETERMINATION OF THE DIALYSIS DOSE AND NUTRITIONAL STATUS OF PATIENTS ON CHRONIC HAEMODIALYSIS

Abstract

An original PC program created in the Centre for Haemodialysis, Clinic of Nephrology, Haemodialysis and Toxicology, Medical University of Varna, and designed for determination of the dialysis dose and nutritional status of patients on periodic haemodialysis (PHD) was presented. The study covered 58 patients on PHD, 24 females and 34 males monitored at 3-month intervals for one year. Using a PC software and this program the following parameters were estimated: single pool model - KT/Vsp, urea reduction rate (URR), and nutrition status (nPCR). The mean KT/Vsp value (single pool) of 1,13 ± 0,14 was close to that recommended by the Dialysis Outcomes Quality Initiative of the National Kidney Foundation. However, a further optimization of dialysis procedures was required. The mean value of protein intake in these patients during the period of observation was of 1,04 ± 0,13 g/kg/d. It should be emphasized that despite the acceptable mean nPCR value the protein intake remained insufficient in 49 per cent of the cases. There was a positive correlation between KT/V and PCR (r = 0,63; p < 0,05). There was no statistically significant difference between the parameters' values from the urea-kinetic modelling (UKM) and those calculated using authors' PC program that testified to the reliability of the results. This program allowed the prognostication of the necessary dialysis dose by rendering an account of the individual patient's parameters and the ultrafdtration required and then by choosing the optimal values of dialysis duration and blood flow.