Hemodialysis Kinetics 101

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KT/V

What is Kt/Vurea?

June 16, 2017 itg

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What is KTv?

  • Kt/Vurea is the measurement of solute removal during hemodialysis often focuses on urea.
  • Urea is considered a surrogate marker for other uremic toxins because it is easily measured in the serum.
  • Urea clearance is the preferred method to assess hemodialysis dose and adequacy.
  • Sargent and Gotch, in 1985, proposed a mathematical model called Kt/V to quantify dialysis dose and dialytic removal of urea.
  • Kt/V is a dimensionless ratio that reflects volume of plasma cleared of urea (Kt) during a conventional hemodialysis session, relative to volume of distribution of urea (V) (V for urea is the total body water or TBW).
  • A Kt/V=1 means that the total volume of blood cleared of urea during a dialysis session is equal to the total body water of the patient.

    • The 'key' to KT/V

    • Basics
      • The Absolute Basics
      • The Hemodialysis Filter
      • Transport Across Membrane
        • Diffusion
        • Convection
      • Transmembrane Pressure
      • High Efficiency vs High Flux
      • Dialyzer Kuf
      • High Efficiency vs Conventional Dialyzers
      • Human Kidney vs Dialyzers
    • Kt/Vurea
      • What is Kt/Vurea?
      • How to Measure Kt/V?
      • What is the goal Kt/V?
      • Why Care About Kt/V?
      • Troubleshooting Low Kt/V
      • Limitations of Kt/V
      • Playground
        • Playground Debrief
    • Clinical Cases
      • Case 1: Dialysis Prescription
      • Case 2: Constrained T
      • Case 3: Access Flow
      • Case 4: Dialyzer Size
      • Case 5: Dialysis Disequilibrium Syndrome
      • Case 6: Access Recirculation
        • Access Recirculation Debrief
      • Case 7: Dialysis Related Amyloidosis
      • End Module

    Namrata Krishnan, MD

    Yale University School of Medicine
    Veterans Affairs Medical Center
    2017

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