Kt/V for Dialysis Adequacy

Results may be used as one measure of dialysis adequacy within a comprehensive assessment that includes vital signs, clinical volume status, weight, symptoms, and laboratory studies.

Target thresholds:

• Hemodialysis:
  
  • Centers for Medicare and Medicaid Services (CMS): ≥1.2 per session (minimum).
  • National Kidney Foundation (NKF): ≥1.4 per session (recommended).
• Peritoneal dialysis: ≥1.7 per week (recommended).

If results are below target:

• Recheck: 
  
  • Sampling technique and calculation.
  • Access patency and function.
  • Dialysis machine variables.
  • Treatment duration (e.g., early termination, temporary cessation, late initiation).
• If reduced dialysis efficiency is suspected, consider increasing dose:
  
  • Longer or more frequent dialysis.
  • Higher blood/dialysate flow.
• Recalculate after any adjustments.