How to Measure Kt/V?

Daugirdas mathematical formula to calculate:
Kt/V  = -ln (R – 0.03) + [(4 – 3.5R) x (UF ÷ W)]

R= post HD BUN/preHD BUN
UF= UF volume in L
W=  post dialysis weight in kg

Online calculators and normograms are available to calculate Kt/V using formula above.

The quick and dirty method:

  • If the dialyzer’s clearance (K) is known (based on the packet insert provide by the manufacturer at a Qb of 400ml/min) and is 250 ml/min and the dialysis session time is 240 minutes (4 hours)
    • then Kt (dialysis dose)= 250 x 240 = 60,000ml or 60 liters
  • If the patient weighs 70kg. His TBW is 60% of 70kg
    • then V = 70 kg multiplied by .60 = 42 liters
  • So the ratio – K multiplied by t to V, or Kt/V  compares the amount of water that passes through the dialyzer and is cleared of urea to the amount of water in the patient’s body.
    • KT/V for this patient will be= 60/42 = 1.42

Caveat: If this same patient has 3 kg of  edema fluid (EDW of 70kg)  then V = 60% (70kg)+ 100%(3kg)= 45L and not 42L. This is because edema fluid adds to the TBW in its entirety as urea distributes evenly across body water.