Individualizing Kt by sex and body surface area: implications for survival in hemodialysis patients

The administration of an adequate dialysis dose is a critical aspect for ensuring the effectiveness of hemodialysis (HD) treatment and improving survival. Kt is a key indicator to evaluate the dose, with two targets: based on sex (Kt-Sx) and body surface area (Kt-BSA). This retrospective study (2022...

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Detalles Bibliográficos
Autores: Sánchez Tocino, M. Luz, López González, Antonio, Iglesias González, María Lorena, Villoria González, Silvia, Audije Gil, Julia, Fernández Martín, José Luis, Hernán, David, Manso, Paula, Dapena, Fabiola, Arenas Jiménez, María Dolores
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/168559
Acceso en línea:http://hdl.handle.net/10366/168559
Access Level:acceso embargado
Palabra clave:body mass index
body surface area-based Kt
dialysis adequacy
dialysis dose
sex-based Kt
Body Mass Index
índice de masa corporal
Descripción
Sumario:The administration of an adequate dialysis dose is a critical aspect for ensuring the effectiveness of hemodialysis (HD) treatment and improving survival. Kt is a key indicator to evaluate the dose, with two targets: based on sex (Kt-Sx) and body surface area (Kt-BSA). This retrospective study (2022-23) was conducted across 15 HD centers analyzed 1829 prevalent patients and 317 842 HD sessions. It was found that 65.9% met both Kt targets, 21.2% met only Kt-Sx and 12.9% met neither. Failure to meet both of the targets was associated with being male, older age, shorter time on HD, higher comorbidity, low body mass index, use of a catheter, shorter sessions, conventional HD, low flow rates and small membranes. Meeting at least the Kt-Sx target was associated with a 41.6% reduction in 24-month mortality risk, and an even more favorable association was observed when both targets were met, reducing the risk by 61.7%. These findings highlight the importance of personalizing dialysis considering both sex and BSA, particularly in overweight or obese patients, to improve survival.