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Dialysis Adequacy — Kt/V
Daugirdas second-generation formula for hemodialysis adequacy
Session Parameters
Required (5–300)
Required (1–200)
Required (60–600 min)
Required (0–10 L)
Required (20–250 kg)
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Kt/V (spKt/V)
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DRR (%)
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R (post/pre BUN)
| Kt/V | DRR | Adequacy | Clinical Action |
|---|---|---|---|
| < 1.0 | < 57% | Inadequate | Increase time, blood flow, or frequency |
| 1.0–1.19 | 57–64% | Below target | Optimize treatment; consider extended time |
| ≥ 1.2 | ≥ 65% | Adequate | Meets KDOQI minimum target |
| ≥ 1.4 | ≥ 70% | Optimal | Exceeds minimum; associated with better outcomes |
Daugirdas 2nd Generation:
R = post-BUN / pre-BUN
t = treatment time (hours)
Kt/V = −ln(R − 0.008×t) + (4 − 3.5×R) × (UF/W)
DRR = (1 − R) × 100%
R = post-BUN / pre-BUN
t = treatment time (hours)
Kt/V = −ln(R − 0.008×t) + (4 − 3.5×R) × (UF/W)
DRR = (1 − R) × 100%
Target: Single-pool Kt/V ≥1.2 per session (thrice weekly HD) per KDOQI guidelines. Monthly monitoring recommended. Factors affecting adequacy: access recirculation, blood flow rate, dialyzer clearance, treatment time, patient compliance. Consider increasing session frequency if adequacy is borderline.
