Wednesday, November 19, 2008

Know Your K's

The constant "K" pops up in many forms in nephrology, particularly in the realm of dialysis, as each dialysis membrane has its own characteristic K values.  

There is first and foremost the Kt/V equation, the currently accepted standard for determining dialysis adequacy.  K here is the dialyzer blood water urea clearance, and in practice one calculates the Kt/V for dialysis patients by measuring their blood urea concentration both before and after dialysis.

Next we have the K(oa), the dialysis mass transfer area coefficient, which describes the efficiency of a given dialyzer in terms of its ability to remove solute.  The K(oa) may be thought of as the maximum possible clearance by a dialyzer at infinitely large blood and dialysate flow rates.  K(oa) values are traditionally reported in cc/min; standard dialyzer K(oa) values are typically 500-700 cc/min with "high efficiency" dialyzers (not to be confused with "high flux" dialyzers--see below) having K(oa)'s > 700 cc/min.

The K(uf) is the ultrafiltration coefficient, and it describes the ability of a given dialyzer to remove fluid at a given transmembrane pressure gradient per unit time.  Dialyzers with a high K(uf) (e.g., >20 cc/hr/mmHg)  are considered "high flux" dialyzers, and these may be especially helpful in patients with large intradialytic weight gains.  

No comments: