Abstract

PINARES ASTETE, Franck Erick; CIEZA ZEVALLOS, Javier Antonio  and  CASTILLO FERNANDEZ, Walter Nelson. Confiabilidad de las mediciones de urea e implicancias en el cálculo del Kt/V en pacientes en hemodiálisis. Rev Med Hered [online]. 2003, vol.14, n.1, pp.5-11. ISSN 1018-130X.

Objective: The reliability of urea measurements and Kt/V estimations at the Peruvian Social Security Institute Laboratory (ESSALUDL) were determined, using as standart the Laboratory of Universidad Peruana Cayetano Heredia (PUCHL). Material and methods: The first phase of this observational study was performed with 19 patients who were aleatorily selected from 90 patients in chronic hemodialysis. It was established intralaboratory urea measurement reliability indexes as well the intralaboratory Kt/V estimation reliability indexes for PUCHL. The second phase was carried out with 79 patients. Same pre and postdialysis samples were taken and distributed in two aliquots for PUCHL and ESSALUDL. It was established interlaboratory urea measurement reliability indexes, as well the interlaboratory Kt/V estimation reliability indexes for PUCHL and ESSALUDL. Results: In the first phase, the correlation among the intralaboratory urea measurements at PUCHL was r=0.99 (p<0.001). The intralaboratory reliability of Kt/V at PUCHL (Kappa coefficient = 0.65) estimated from the observed agreement of 73.6% and the expected agreement of 25.3%, was found high. In the second phase, the correlation among the interlaboratory urea measurements was r=0.93 (p<0.001); for urea measurements above 100mg%, the correlation was r=0.48 (p>0.05). The interlaboratory reliability of Kt/V (Kappa coefficient = 0.26) estimated from the observed agreement of 49.4% and the expected agreement of 31.4% was found low. Conclusions: There is a significative statistical correlation among the urea measurement of both laboratories; however this correlation is low for values above 100mg%. The Kt/V agreement between both laboratories is low because the urea measurements at ESSALUD laboratory are not reliable. (Rev Med Hered 2003; 14:5-11).

Keywords : Urea; variations Kt/V; hemodialysis adequacy.

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