Welcome to Open Science
Contact Us
Home Books Journals Submission Open Science Join Us News
Evaluation of Haemodialysis Adequacy Using Urea Reduction Ratio (URR) in Adult Patients with End Stage Renal Disease in Benin City
Current Issue
Volume 6, 2019
Issue 2 (June)
Pages: 5-9   |   Vol. 6, No. 2, June 2019   |   Follow on         
Paper in PDF Downloads: 30   Since Sep. 23, 2019 Views: 661   Since Sep. 23, 2019
Mathias Abiodun Emokpae, Department of Medical Laboratory Science, School of Basic Medical Sciences, University of Benin, Benin City, Nigeria.
Prosper Omigie, Department of Chemical Pathology, University of Benin Teaching Hospital, Benin City, Nigeria.
The quality of haemodialysis is a predictor of mortality in patients with End Stage Renal Disease. The Urea Reduction Ratio (URR) is a simple and most popular method used in clinical practice to assess the effectiveness of delivered haemodialysis dose after a session of dialysis. This study evaluates the adequacy of haemodialysis dose in patients with end stage renal disease (ESRD). This is a cross sectional study of 52 patients with ESRD; 30 males (57.7%) and 22 females (42.3%) on maintenance haemodialysis. Pre-dialysis and post-dialysis blood specimens were collected; urea, creatinine and electrolytes were assayed by spectrophotometric technique and Ion Selective Electrode (ISE) analyzer respectively. The URR was calculated and used as a measure of haemodialysis adequacy. The URR of 61.0±3.2% was observed which is lower than URR of ≥65% recommended by the Kidney Disease outcome Quality Initiative guidelines. The data presented in this study indicate a lower haemodialysis adequacy in patients with ESRD. It is suggested that comprehensive approach may be adopted in order to achieve the recommended URR of ≥65%. The government should create more functional haemodialysis facilities and subsidize treatment so that every individual no matter the socioeconomic status can be treated.
End Stage Renal Disease, Haemodialysis Adequacy, Urea Reduction Ratio
Barzegar H, Moosazadeh M, Jafari H, Esmaeili R. Evaluation of D. Evaluation of Dialysis adequacy in Haemodialysis patients: A systematic review. Review 2016; 13 (4): 2744-2749.
dos Reis Santos I, Danaga AR, de Carvalho Aguiar I, Olivier EF, Dias IS, Urbano JJ et al. Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial. BMC Nephrol. 2013; 14: 215.
Tayyebi A, Shasti S, Ebadi A, Eynollahi B, Tadrisi SD. The relationship between blood pressure and dialysis adequacy in dialysis patients. J Crit Care Nurs. 2012; 5: 49-54.
El-Sheikh M, El-Ghazaly G. Assessment of hemodialysis adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta University Hospital in Egypt. Indian J Nephrol 2016; 26: 398-404.
Hall YN, Jolly SE, Xu P, Abrass CK, Buchwald D, Himmelfarb J. Regional differences in dialysis care and mortality among American Indians and Alaska Natives. J Am Soc Nephrol 2011; 22: 2287‑95.
Delmez JA, Windus DW. Haemodialysis prescription and delivery in a metropolitan community. Kidney Int. 1992; 41: 1023-28.
Sunanda V, Santosh B, Jusmita D, Prabhakar BR. Achieving the Urea Reduction Ratio (URR) as a predictor of the Adequacy and the NKF-K/DOQI target for calcium, phosphorus and Ca xP product in ESRD patients who undergo Haemodialysis. J Clin Diagn Res 2012; 6 (2): 169-172.
US Renal Data Systems. The USRDS dialysis morbidity and mortality study (wave 1). National Institutes of Health, National Institute Diabetes and Digestive and Kidney Diseases. Annual Data Report 1996. Bethesda, MD. 1996; 45-67.
European Best Practice Guidelines Expert Group on Haemodialysis. Nephrol Dial Transplant 2002: 17 (Suppl 7): S16–S31.
NKF-KDOQI clinical practice guidelines; update 2006. Am J Kidney Dis 2006: 48 (Suppl 1): S2–S90.
Couchoud C, Jager KJ, Tomson C, Cabanne JF, Collart F, Finne P et al. Assessment of urea removal in haemodialysis and the impact of the European Best Practice Guidelines. Nephrol Dial Transplant. 2009; 24: 1267-1274.
National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Haemodialysis Adequacy, 2000. Am J Kidney Dis. 2001 (suppl 1); 37: S7-S64.
Chijioke A, Aderibigbe A, Rafiu MO, Olanrewaju TO, Makusidi AM. The Assessment of Haemodialysis Adequacy among ESRD patients in Ilorin using Urea Reduction Ratio. Trop J Nephrol 2009; 4 (2): 115-119.
Yeldu MH, Makusidi MA, Mainasara AS, Usman SN, Erhabor O. Assessment of Haemodialysis among ESRD Patients in Sokoto using Urea Reduction Ratio and serum Albumin concentration. Asian J Sci Technol 2015; 6 (2): 1044-11050.
Andrew S, Jay B. Hemodialysis adequacy. In: Henrich WL, editor. Principles and Practice of Dialysis. 4th ed., Ch. 8. Wolters Kluwer Health: Lippincott Williams and Wilkins Publications; 2009. p. 106‑22.
Agaba EL, Lopex A., Ma I, Martinex R, Tzamaloukas RA. Inadequacy of Dialysis, Chronic Inflammation and Malnutrition in Nigerian Patients on Chronic Haemodialysis. Int J Artificial Organ 2006; 29 (1): 1067-1073.
Amira CO and Mamvem M. Effect of Dialyzer Reuse on Dialyzer Performance. Niger Med J 2007; 48 (2): 42-45.
Pourfarziani V, Ghanbarpour F, Nemati E, Taheri S, Einollahi B. Laboratory Variables and Treatment Adequacy in Hemodialysis Patients in Iran. Saudi J Kidney Dis Transplant 2008; 19 (5): 842-846.
Manandhar DN, Chetri PK, Pahar LR, Tiwari R, Chowdhary SK. Nutritional Assessment of Patients Under Haemodialysis in Nepal Medial College Teaching Hospital. Nepal Med Coll J 2008; 10 (3): 164-169.
Afshar R, Sanavi S, Izadi-Khah A. Assessment of Nutritional Status in Patients Undergoing Maintainance Haemodialysis: A Single- Centre Study from Iran. Saudi J Kidney Dis Transplant 2007; 18 (3): 397-404.
Amini M, Aghighi M, Masoudkabir F, Zamyadi M, Norouzi S, Rajolani H, Rasouli MR, Pourbakhtyaran C. Haemodialysis Adequacy and Treatment in Iranian Patients. Iranian J kidney Dis 2011; 5 (2): 103-109.
Shrestha S, Ghotekar LR, Sharma SK, Shangwa PM, Karki P. Assessment of Quality of Life in Patients of End Stage Renal Disease on Different Modalities of Treatment. J Nepal Med Assoc 2008; 47 (169): 1-6
Dordevic V, Stojanovic M, Stefanovic V. Adequacy of Haemodialysis in a Large University Affiliated Dialysis Centre in Serbia. Scientific J Facts Universitalis 1999; 6 (1): 107-111.
Mohseni R, Ilali ES. Assessment of Adequacy of Dialysis in Patients Undergoing Dialysis with Bicarbonate Solution. Hayat. 2011; 17: 63- 72.
Mogharab M, Madarshahian F, Rezai N, Mohammadi A. Dialysis adequacy in chronic hemodialysis patients in educational center Vali-Asr in Birjand. J Birjand Univ Med Sci. 2010; 17: 206-214.
Arogundade, F. A., Sanusi, A. A., Hassan, M. O. and Akinsola, A. 2011: The Pattern, Clinical Characteristics and Outcome of End Stage Renal Disease in Ille- Ife, Nigeria, Is There a Change in Trend? Afri Health Sci 11 (4): 594-601.
Odufuwa B A, Fadupin GT. Nutritional Status of Hemodialysis Patients in a Developing Economy: A Case Study in Nigeria. J Human Ecol 2011; 36 (2): 111-116.
Okafor UH, Ekwem I, Wokoma FS. Haemodialysis Treatment for End Stage Chronic Kidney Disease and Acute Kidney Injury in Africa. Niger Med J 2012; 53 (1): 47-50.
Adas H, Al-Ramahi R, Jaradat N, Badran R. Assessment of adequacy of hemodialysis dose at a Palestinian hospital. Saudi J Kidney Dis Transpl. 2014; 25: 438-442.
Chijioke A, Adeniyi AB. End stage renal disease: Racial differences. OJM. 2003; 15: 24-31.
Alebiosu CO, Olugbenga O A, Adigun A, Ina OA. Chronic Renal Failure at the Olabisi Onabajo University Teaching Hospital Sagamu Nigeria. Afr Health Scis, 2006; 6 (3): 132-138.
National Kidney Foundation/Kidney Disease Outcomes Quality Initiative (NKF/KDOQI). Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis 2007; 49 Suppl 2: A1-A6, S1-182.
Arogundade FA, Barsoum RS. CKD Prevention in Sub-Saharan Africa: A Call for Governmental, Nongovernmental, and Community Support. Am J Kidney Dis 2008; 51 (3): 515-523.
Amoako AY, Laryea DO, Beddu-Addo G, Andoh H, Awuku YA. Clinical and Demographic Characteristics of Chronic Kidney Disease Patients in a Tertiary Facility in Ghana. The pan Afr Med J 2014; 18 (1): 274-279.
Iseki K, Kawazco N, Osawa A, Fukiyama K. Survival Analysis of Dialysis Patients in Okinawa, Japan. Kidney Int 1993; 43 (1): 404-409.
Kurokawa K, Nangaku M, Saito A, Inagi R, MiyataT. Current Issues and Future Perspectives of Chronic Renal Failure. J Am Soc Nephrol 2002; 13 (1): S3-S6.
Ullasi H, Ijeoma CK. The Enormity of Chronic Kidney Disease In Nigeria, The Situation In A Teaching Hospital In South-East. Niger J Trop Med 2010; 1: 501-957
Ekrikpo UE, Udo IA, Ikpeme EE, Effa EE. Haemodailysis in an Emerging Centre in a Developing Country: A Two Year Review and Predictors of Mortality. BMC nephrol 2011; 50 (12): 1471- 2369.
Eghan BA, Amoako-Atta K, Kankam CA, Nsiah-Asare, A. Survival Pattern of Haemodialysis Patients In Kumasi, Ghana: A Summary of Forty Patients Initiated on Haemodialysis, At a New Haemodialysis Unit. Haemodialysis Int 2009; 13 (4): 467- 471.
Aggarwal HK, Jai ND, Sahney A, Bansal T, Yadav RK, Kathuria KL. Effect of Dialyser Reuse on the Efficacy of Haemodialysis in Patients of Chronic Renal Disease in Developing World. J Int Med Acad 2012; 25 (2): 81-83.
Open Science Scholarly Journals
Open Science is a peer-reviewed platform, the journals of which cover a wide range of academic disciplines and serve the world's research and scholarly communities. Upon acceptance, Open Science Journals will be immediately and permanently free for everyone to read and download.
Office Address:
228 Park Ave., S#45956, New York, NY 10003
Phone: +(001)(347)535 0661
Copyright © 2013-, Open Science Publishers - All Rights Reserved