Effect of Hemodialysis Duration on Urea Reduction Ratio and KT/V Target among End-Stage Renal Failure Patients

Background: The study aimed to determine the association of dialysis treatment duration with the adequacy of hemodialysis among patients as indicated by Urea Reduction Ratio, URR and Kt/V.

Methods: The study employed a quasi-experimental clinical research study design of purposive sampling technique from 60 samples of hemodialysis patients in a private hospital in Kota Kinabalu. The two groups were categorised as shorter 3 hours and conventional 4 hours dialysis duration. Blood urea levels of pre and post-dialysis treatment were used as biomarkers to identify the adequacy of dialysis treatment.

Results: The study paired t-test findings indicate that participants of 3 hours HD duration had a mean blood urea level pre-dialysis of 24.34 (SD =4.99), which was significantly higher than the 43 participants of 4 hours HD duration mean blood urea level of 20.11, t (42) =2.59, p <0.13. Similarly, for participants of shorter HD duration, the mean blood urea level post dialysis of 9.31 (SD =3.41) was also significantly higher than the 4 hours HD duration participants with mean blood urea level of 6.59, t (29) =2.81, p <0.009. The major finding of the study using a two-way analysis of variance yielded a main effect for the Kt/V, F (1,58) = 6.36, p <0.14, such that the average Kt/V was significantly higher in 4 hours HD durations (M=1.38, SD=0.29) than the 3 hours HD durations (M=1.17, SD=0.30). It is also similarly significant for the Urea Reduction Ratio, F (1,59) =4.425, p <0.04, in which 4 hours HD durations (M=67.78, SD=8.63) compared to 3 hours HD durations (M=62.45, SD=.44).

Conclusion: Achieving the advised treatment durations regime a bare minimum of 4 hours per session are recommended for patients with significant weight gain, high ultrafiltration rates, difficulty achieving dry weight, or inadequate metabolic control (such as hyperphosphatemia, metabolic acidosis, and hyperkalaemia) may require additional hemodialysis sessions or longer hemodialysis treatment times.

Keywords: Dialysis Adequacy, Urea Reduction Ratio, KT/V, Dialysis Duration.