Adequacy Panels

HEMODIALYSIS

Kt/V Jindal (Not K/DOQI Recommended)

• Jindal calculation

• Does not require draw information

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

Kt/V Natural Log, URR

• Daugirdas II calculation

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

• Includes Pre BUN, Post BUN, URR, UFR, Kt/V Natural Log

• CMS requirement for patients dialyzing 3 times per week

Kt/V Natural Log, URR, nPNA (3x/wk)

• Daugirdas II and Depner calculations

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

• Includes Pre BUN, Post BUN, URR, UFR, Kt/V Natural Log, nPNA

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

Kt/V Standard, Natural Log, URR

• Leypoldt and Daugirdas II calculation

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

• Includes Pre BUN, Post BUN, URR, UFR, Kt/V Standard and Kt/V Natural Log

• CMS requirement for patients dialyzing 2 or 4-6 times per week

Kt/V Standard, URR (<>3x/wk)

• Leypoldt calculation

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

• Includes Pre BUN, Post BUN, URR, UFR, Kt/V Standard

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

Kt/V Residual

• Kt/V Residual calculated when Residual Urea Clearance ordered together with Kt/V Natural Log or Kt/V Standard; assesses total adequacy and is included on a patient report up to 90 days.

• Requires draw information: 24-hr urine collection time, urine volume, dry weight, height

• Includes Pre BUN, KrU, Urine Urea Nitrogen, Kt/V Residual

PERITONEAL DIALYSIS

PD Adequacy No Urine

• Volume of Distribution (V): Hume and Weyers for Adult; Friis-Hansen for Peds <16 years 

• Body Surface Area (BSA): Dubois and Dubois for Adult; Haycock for Peds <16 years

• Protein Nitrogen Appearance (PNA): Bergstrom

• 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, Weekly Dialysate CrCl, nPNA

PD Adequacy With Urine

• Volume of Distribution (V): Hume and Weyers for Adult; Friis-Hansen for Peds <16 years 

• Body Surface Area (BSA): Dubois and Dubois for Adult; Haycock for Peds <16 years

• Protein Nitrogen Appearance (PNA): Bergstrom

• Requires the following draw information (dry weight, height, total urine collection 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, Weekly TotalKt/V, Weekly Dialysate CrCl, Weekly Residual GFR, Weekly Total CrCl, Weekly Residual CrCl, and nPNA