Comparison of urea reduction ratio and dialysis efficacy in evaluating haemodialysis adequacy in chronic kidney disease patients in Wangaya Hospital


  • Katarina D. Sartika Department of Internal Medicine, Wangaya Hospital, Denpasar, Bali, Indonesia
  • I. Wayan Sunaka Department of Internal Medicine, Wangaya Hospital, Denpasar, Bali, Indonesia



Adequacy of hemodialysis, CKD, URR, Kt/V


Background: An increasing number of patients with chronic kidney disease (CKD) impact an increased need for hemodialysis. Inadequate hemodialysis affects morbidity in patients with CKD. Determination of the urea removal index can be accomplished by several invasive and non-invasive methods. The purpose of this study was to compare the urea reduction ratio (URR) and dialysis efficiency (Kt/V) calculated automatically by hemodialysis machines to assess the adequacy of hemodialysis in patients with CKD.

Methods: A cross-sectional analysis study was conducted on 58 CKD patients with age ≥18 years, conventional 5-hour hemodialysis sessions twice weekly, using single use-hollow fiber dialyzers, and who had been receiving hemodialysis for ≥6 months in the hemodialysis unit at Wangaya Hospital from April 2022 to May 2022. Study data were obtained from medical records then described and analyzed using the statistical package for the social sciences (SPSS) program.

Results: The mean of URR was 70.74±10.04, while the mean of Kt/V delivered by machine was 1.27±0.19. More hemodialysis patients received adequate hemodialysis based on URR parameters compared to Kt/V parameters (84.5% versus 1.7%). There was no significant difference between age, sex, body mass index (BMI), comorbidities, vascular access and duration of dialysis with adequacy hemodialysis. There was a significant difference between URR and Kt/V in the evaluation adequacy of hemodialysis (p=0.000). In addition, there was a positive correlation between URR and Kt/V in the evaluation adequacy of hemodialysis (r=0.592, p=0.000).

Conclusions: The URR is a more accurate parameter, but the Kt/V delivered by machine can help the URR demonstrate the adequacy of haemodialysis patients with CKD.

Author Biography

Katarina D. Sartika, Department of Internal Medicine, Wangaya Hospital, Denpasar, Bali, Indonesia

General Practitioner, Wangaya Hospital, Denpasar, Bali, Indonesia


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