| Theme | Risk Factors and Outcome on Long-term Dialysis | |
|---|---|---|
| Title | Long-term prognosis and risk factor of hemodialysis patients : Does of dialysis | |
| Publish Date | 2000/06 | |
| Author | Junichi Ono | Clinical Engineer, Kawasaki Medical School Hospital |
| Author | Shinsuke Nomura | Division of Nephrology, Kawasaki Medical School Hospital |
| Author | Takehiko Tokura | Division of Nephrology, Kawasaki Medical School Hospital |
| Author | Tatsuo Fukushima | Division of Nephrology, Kawasaki Medical School Hospital |
| Author | Tamaki Sasaki | Division of Nephrology, Kawasaki Medical School Hospital |
| Author | Naoki Kashihara | Division of Nephrology, Kawasaki Medical School Hospital |
| [ Summary ] | From the viewpoints of longevity and long-term prognoses, the adequacy of dialysis procedures is a very critical issue for hemodialysed patients. How long hemodialysis should be used, how much it should be prescribed, and what uremic toxins should be actively removed have been matters of discussion, as has been the method for evaluating the adequacy of hemodialysis. Today, uremic toxins are classified into two groups by molecular weight ; that is, low molecular weight toxins and medium molecular weight toxins. To date, when focusing on the low molecular weight toxins, the Kt/V index, a measurement of urea kinetics, has been the most well evaluated regarding long-term prognosis for patients. Based on many controlled studies, it has been revealed that improvements in the index can extend the survival rate and improve the quality of life for these patients. In a clinical setting, the maintenance of a Kt/V value between 1.2 and 1.8 is recommended as optimal for hemodialysis patients. In contrast, there is little objective evidence regarding middle molecular weight toxins. The introduction of high-flux dialysis has lowered the risk of death for hemodialysis patients, but, there is still no useful index, such as the Kt/V index, for medium molecular weight toxins. |
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