When I was in-center I always thought it odd that they would only draw labs after the long weekends without dialysis. It occured to me recently that perhaps they did this intentionally to produce higher Kt/v numbers. I know my numbers are better of I do labs after a day off. The worse the blood is before dialysis measured against cleaner blood after dialysis produces higher ‘adequacey’ numbers.
Dark thought but this is not in the patients’ best interests. Could it be that centers purposely try to inflate the numbers to keep patients with as little dialysis as possible and meet the current standards? I don’t doubt this has already been discussed somewhere…
Many clinics draw labs after the 2 day weekend to measure the patients’ potassium, phosphorus, sodium, etc. at their highest levels in the blood, not to game dialysis adequacy. Lab tests are typically drawn the same day of the month for consistency. The blood for Kt/V or URR should be drawn during one dialysis treatment. The measure of dialysis adequacy can be off if the staff of the dialysis clinic (or the home patient) draws the pre or post-dialysis blood incorrectly. You can read about monitoring dialysis adequacy in the Core Curriculum for the Dialysis Technician published by Medical Education Institute, Inc. starting on page 188. Since home dialysis patients are their own technicians, this may be a handy reference for patients too.
http://www.meiresearch.org/pdfs/2008CCBook.pdf