Adequacy Panels

Ascend Clinical offers a variety of adequacy panels in LabCheck.
HEMODIALYSIS

Kt/V Jindal

  • Not KDOQI recommended

  • Jindal

  • Does not require draw information

  • Includes Pre BUN, Post BUN, URR, Kt/V Jindal calculation

Kt/V Natural Log, URR

  • KDOQI recommended

  • Daugardis II (Single Pool)

  • Requires the following draw information (pre-weight, post-weight, treatment time)

  • Includes Pre BUN, Post BUN, URR, Kt/V Daugardis II calculation

Kt/V Natural Log, URR, nPNA

  • Requires the following draw information (pre-weight, post-weight, treatment time, treatment number)

  • Includes Pre BUN, Post BUN, URR, Kt/V Daugardis II calculation

  • nPNA calculated from Kt/V without formal kinetic modeling by Depner and Daugardis using thrice-weekly dialysis

Kt/V Standard, URR

  • CMS requirement for patients dialyzing 2 or 4-6 times per week (Measures Assessment Tool)

  • Leypoldt

  • Requires the following draw information (pre-weight, post-weight, treatment time, number of treatments per week)

  • Includes Pre BUN, Post BUN, URR, Kt/V Leypoldt calculation

 

 

 

PERITONEAL DIALYSIS

PD Adequacy No Urine

  • Hume and Weyers for Volume of Distribution (V)

  • Dubois for Body Surface Area (BSA) 

  • Bergstrom for Protein Nitrogen Appearance (PNA)
  • Requires draw information (dry weight, height, 24 hr total drain volume)

  • Includes Blood BUN, Blood Creatinine, Fluid Glucose, Fluid Urea Nitrogen, Fluid Creatinine, Weekly Dialysate Kt/V

PD Adequacy With Urine

  • Hume and Weyers for Volume of Distribution (V)

  • Dubois for Body Surface Area (BSA)

  • Bergstrom for Protein Nitrogen Appearance (PNA)

  • Requires the following draw information (Dry weight, Height, Urine start date, Urine end date, Urine start time, Urine end time, Urine volume, 24-hr total drain volume)

  • Includes Blood BUN, Blood Creatinine, Fluid Glucose, Fluid Urea Nitrogen, Fluid Creatinine, Urine Urea Nitrogen, Urine Creatinine, Weekly Dialysate Kt/V, Weekly Residual Kt/V and Weekly Total Kt/V

 

FORMAL UREA KINETIC MODELING (UKM)

Formal Kinetic Modeling is also available in LabCheck for patients dialyzing 2-3 times per week. Per KDOQI, formal kinetic modeling provides a quantitative method for developing a treatment prescription for a specific patient. Formal UKM can be used to calculate the exact treatment time required to deliver a particular hemodialysis dose at specified blood and dialysate flows with a particular dialyzer.

RESOURCES

AJKD: https://www.ajkd.org/article/S0272-6386(15)01019-7/fulltext

CMS: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Dialysis.html

KDOQI: https://www.kidney.org/sites/default/files/docs/12-50-0210_jag_dcp_guidelines-hd_oct06_sectiona_ofc.pdf