Effective ionic dialysis—a modern perspective for assessing dialysis adequacy

Introduction: The delivered dialysis dose is the most important predictor of optimal clinical outcome and quality of life achieved in the growing population of hemodialysis (HD) patients. Currently, it is monitored most often once a month, and in some countries for a longer period. It is based on the Dialysis Adequacy Indicators validated by the Kidney Disease Quality Outcome Initiative (KDQOI) using urea-kinetic modeling (UKM) - spKt/V and Urea reducing ratio (URR). Despite the fact that with strict adherence to the rules of good clinical practice, the assessment of spKt/V by blood samples can give an adequate estimate of the dialysis dose, the use of mathematical calculations can sometimes be a limitation in the busy daily life of doctors. We accept that the single measurement is representative of the whole dialysis prescription, so this creates conditions for the omission of important events that worsen the clinical outcome and can be fatal for hemodialysis patients. Measurement of dialysis adequacy is now achievable for each dialysis session without the need for additional blood tests, and the results are available in real time through the use of efficient ionic dialysis technology based on measuring the difference in ionic conductivity for sodium at the dialyzer inlet and outlet.Aim: The aim of the article is to analyze the comparability, reliability and safety of effective ionic dialysis as a method for estimating the delivered dialysis dose against the dialysis adequacy validated by KDOQI.Materials and Methods: A detailed review and analysis of the literature on the topic in the world-famous scientific databases was carried out, considering the methodology, the main advantages, shortcomings, and possible risks of the studied technology.Conclusion: Ionic dialysis is a new non-invasive tool for daily use with high correlation and predictive value in relation to the classic indicators of dialysis adequacy - spKt/V and URR, which allows monitoring of the delivered dialysis dose in real time without blood ...