End Stage Renal Disease(ESRD) is an irreversible stage of Chronic Renal Failure where Glomerular FiltrationRate is less than 15 ml per min per 1.73 m2 of surface area. It hasbeen described as the fifth and the final stage of Chronic Renal Failure byNational Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF-K/DOQI) 1. An Indian population based studies shows the crude andage-adjusted ESRD incidence rate averaged around 151 and 232 per million populationsper annum respectively 2. There are two majortypes of Renal Replacement Therapy, available as treatment for ESRD patients –Kidney transplantation and dialysis 3.
Renal transplantation isbeyond the scope of affordability for the middle and lower socio -economicstatus patients. Therefore dialysis remains the most widely used treatmentmodality. Hemodialysis and peritoneal dialysis are the two major forms of dialysis,where former is usually preferred over later.
Urea is traditionally used assolute marker for dialysis quantification, because of its small size, readilydialyzable solute which is a bulk catabolite of protein, easily measurable inblood and its clearance corresponds to the patient’s mortality. NKF – K/DOQIconsiders three methods as appropriate for measuring adequacy of hemodialysis –Urea Kinetic modelling, Kt/v and Urea Reduction Ratio (URR) 4. Dialysisadequacy, introduced in 1970’s, refers to the dose of dialysis, which is deliveredto the patients, is considered good enough to promote an ideal long term outcome.
It implies that a patient should have a normal Quality of Life and solidclinical tolerance with minimum level of problems, during and after a dose ofdialysis 5. Adequacy of hemodialysis is of considerable importancesince it has direct correlation with patient’s mortality. Inadequatehemodialysis leads to anaemia, malnutrition, functional impairment, frequenthospitalization and poor patient survival 6. The solute removal canbe drastically augmented by increasing the frequency of hemodialysis session.Several uncontrolled studies show that there was a significant improvement inpatient –reported outcome and results of laboratory tests when patients weretreated with more frequent hemodialysis 7.
The best availableevidences at present indicate an uncertainty regarding the optimal dose ofhemodialysis. So the present study is designed to compare the effectiveness ofthree hemodialysis sessions per week with two hemodialysis sessions per weekusing URR and Kt/v.Objectives:1. To compare the effectiveness of thriceweekly hemodialysis with twice weekly hemodialysis by evaluating blood urea, serumcreatinine, URR and Kt/v2.
To estimate concentration of blood ureaand serum creatinine before and after hemodialysis.