hello i just found out my urr is 63 after a 8 hour treatment not good any suggestion how i can improve this and whats your urr i am doing every other day 8 hour treatment.
From the National Kidney Foundation website:
“… Know your Kt/V and URR (urea reduction ratio). Kt/V and URR are numbers that tell you how much dialysis you are getting. The NKF recommends using Kt/V. [emphasis added] If you are receiving enough dialysis, your Kt/V should be at least 1.2. If URR is used, it should be 65 % or more. …” Do you know your Kt/V?
I assume that you know this, but the URR is calculated from the change in BUN divided by the predialysis BUN. What was your last predialysis BUN and what was your last postdialysis BUN. The NKF K/DOQI guidelines that recommend a URR of 65% (this is the floor, not the ceiling) were developed based on a review of the literature of studies with patients on dialysis three times a week. The guidelines say that Kt/V of 1.2 is approximately equal to a URR of 63%. As far as I know, there are no guidelines for dialysis treatments that are done for more hours or more days a week than 3. However, usually dialysis adequacy is higher.
Talk with your doctor and/or home training nurse and ask if your URR is out of line for someone on nocturnal hemodialysis. If so, ask what could be affecting your URR. They may want to re-draw your labs to see if the results are the same or different. They may want to evaluate your dialysis access to see if it is working as well as it should. There could be a narrowing of the blood vessel. There can be recirculation if dialysis needles are inserted to closely together. Any of these things can reduce dialysis adequacy.