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6 J!K?!+$%!# ID O.! J%.! H$I& m #! H$+3 #!.! " 32 / KT/V :$ O2N #! ÅI v.m H H? W= F= VM # #2.! /+7 /27 URR # ".! #2!K? H7 ) 6.!!!K? H + #3 Hk% #!!#! I 3) 6 H7!!I H7 %# #2 G# #2.! :$ & & #=.!23 />? LD.! #! HN$ 6 #2 G. W Ä5 #2 /KB ]M 3H3 #2.! /+7 "#! %# HN$ #!.! 3-.!!& HD? ) #U&[q? F FK? #! /=! *- #-!?QQ>? Ñ_ HN$ HK.M G "#I JQQ>? T6) $> /K 6./%.! 45 $> F% 6C ) F%! (:) 8. #! 6) 7 6) G!4 #! # vn H7 7 G #WD #2.!!#=?!2 "# 43P 3! 20 6 $27 H BMI 437 H7 j GÉ? /I#! # 437 HUp? y% 6 FQ H) Y%7 43P #!. ^.$ 437 Jp? 7q? H.q G (#23 Daugirdas.(7) /% H$- [ - # G BMI #Q.!?k - X2 #! #2 Hj3 6 HM# G #!./! "$ 4I 3) KT/V D#! 25 H - 4I #23 I7.! A H /%! #! W= - H /W.(23) /% [ #2 " #! / H% H7 #2 #!.! /+7 %# G #!! H7! #2 6 4 $I& #=.! />? H$+3 6 T#& HN$ G.$!.! H$+3 #! / N? %# M H.(22)!#! 523 #23 #2 " H$I& m #!.! "P?$% #! m? / H% H H$+3 #! /! 6 3) H p?.!! 4I # 3).! / KT/V #Q G% 4I BC HK.M #!!W #!K "#) m 6 ) /%! H gw?# j 3 /I J#D H gw?# G #23 C "% HK.M #! #! %# m H HN$ #! (24) /!! #!K 4I FW= 6?228??G #2.! References 1. Harrison TR, Kasper DL. Harrison's principles of internal medicine. 16 th ed. New York: McGraw-Hill; Hakim RM, Depner TA, Parker TF, III. Adequacy of hemodialysis. Am J Kidney Dis 1992; 20(2): Chauveau P, Nguyen H, Combe C, Chene G, Azar R, Cano N, et al. Dialyzer membrane permeability and survival in hemodialysis patients. Am J Kidney Dis 2005; 45(3): Hakim RM, Breyer J, Ismail N, Schulman G. Effects of dose of dialysis on morbidity and mortality. Am J Kidney Dis 1994; 23(5): Acchiardo SR, Hatten KW, Ruvinsky MJ, Dyson B, Fuller J, Moore LW. Inadequate dialysis increases gross mortality rate. ASAIO J 1992; 38(3): M282-M Held PJ, Port FK, Wolfe RA, Stannard DC, Carroll CE, Daugirdas JT, et al. The dose of hemodialysis and patient mortality. Kidney Int 1996; 50(2):

7 7. Daugirdas JT, Blake PG, Ing TS. Hand Book of Dialysis. 2 nd ed. Phildelphia: Lippincott Williams & Wilkins; p Kovacic V, Sain M, Dzanko D. Effect of gender and body mass on hemodialysis dose. Acta Med Croatica 2003; 57(1): Hemodialysis Dose and Adequacy. National Kidney and Urologic Diseases Information Clearinghouse [online]. 2005; Available from: URL: Leon JB, Sehgal AR. Identifying patients at risk for hemodialysis underprescription. Am J Nephrol 2001; 21(3): Monfared A, Orang Pour R, Kohani M. Evaluation of Hemodialysis Adequency on Patients Undergoing Hemodialysis in Razi Hospital in Rasht. Journal Of Guilan University Of Medical Sciences 2008; 17(65): [In Persian]. 12. Ing T, Cheng Y, Shek C, Wong K, Yang V, Kjellstrand C, et al. Observations on urea kinetic modeling and adequacy of hemodialysis. Hong Kong Journal of Nephrology 2010; 2(1): Curtis JJ. Treatment of irreversible renal failure,dialysis. In: Fayette Cecil RL, Bennett JC, Plum F, Editors. Cecil textbook of medicine. Philadelphia: Saunders, p Leonard MB, Stablein DM, Ho M, Jabs K, Feldman HI. Racial and center differences in hemodialysis adequacy in children treated at pediatric centers: a North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) report. J Am Soc Nephrol 2004; 15(11): Prado M, Roa L, Palma A, Milan JA. A novel mathematical method based on urea kinetic modeling for computing the dialysis dose. Comput Methods Programs Biomed 2004; 74(2): Mozaffari N, Mohammadi MA, Dadkhah B, Mahdavi A. Dialysis Adequacy of Haemodialytic Patients in Ardabil Dialysis Center Journal of Ardabil University of medical sciences 2005; 4(14): [In presian]. 17. Moslem AR, Naghavi M, Basiri Moghadam M, Gharache M, Basiri Moghadam K. Assessing the adequacy of dialysis and its relationship with kind of filter in patient under hemodialysis referred to 22-Bahman hospital of Gonabad. Ofogh e Danesh, Journal of Gonabad University of Medical Sciences And Health Services 2008; 14(2): [In presian]. 18. Taziki A, Kashi Z. Determination of dialysis sufficiency in the patients referring to dialysis center of Fatemeh Zahrah Hospital of Sari in Journal of Mazandaran University of Medical Sciences 2003; 13(41): [In presian]. 19. Santoro A, Mancini E, Bolzani R, Boggi R, Cagnoli L, Francioso A, et al. The effect of on-line high-flux hemofiltration versus low-flux hemodialysis on mortality in chronic kidney failure: a small randomized controlled trial. Am J Kidney Dis 2008; 52(3): Chauveau P, Nguyen H, Combe C, Chene G, Azar R, Cano N, et al. Dialyzer membrane permeability and survival in hemodialysis patients. Am J Kidney Dis 2005; 45(3): Termorshuizen F, Dekker FW, van Manen JG, Korevaar JC, Boeschoten EW, Krediet RT. Relative contribution of residual renal function and different measures of adequacy to survival in hemodialysis patients: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. J Am Soc Nephrol 2004; 15(4): Zand S, Hasan-khani H, Soltani P. An investigation on the efficacy of hemodialysis in Vali-e-Asr hospital of Arak city based on urea kinetic model in year Rahavard Danesh, Jounal of Arak university of Medical Sciences 2007; 10(1): [In presian]. 23. Borzou SR, Golyaf M, Amini R, Zandihe M, Torckman B. The Effect of Increase in Blood Flow Rate on Phosphor and Potassium in Hemodialysis patients. Journal of Ardabil University of Medical Sciences & Health Services 2008; 8(29): [In presian]. 24. Mousavi Movahed SM, Komeili Movahed T, Komeili Movahed A, Dolati M. Assessment of Adequacy of Dialysis in Patients under Continuous Hemodialysis in Kamkar and Hazrat Vali Asr Hospitals, State of Qom. Journal of Gom University of medical Sciences 2007; 1(2): [In presian]. 212

8 25. Gorman G, Furth S, Hwang W, Parekh R, Astor B, Fivush B, et al. Clinical outcomes and dialysis adequacy in adolescent hemodialysis patients. Am J Kidney Dis 2006; 47(2): Dordevic V, Stojanovi M, Stefanovi V. Adequacy of Hemodialysis In A Large University-Affiliated Dialysis Centre In Serbia. Medicine and Biology 1999; 6(1): Shahbazian H, Poorvays Z. Study on the adequacy of haemodialysis in Sina Hospital. Journal of Ahwaz University of Medical Sciences 2002; 4(33): [In presian]. 213

9 Abstract Original Article Dialysis adequacy in chronic hemodialysis patients in educational center Vali-Asr in Birjand M. Mogharab 1, F. Madarshahian 2, N. Rezai 3, A. Mohammadi 4 Background and Aim: In present more than one million people in world doing hemodialysis, This study do to determine adequacy of dialysis in hemodialysis patients Vali-Asr Hospital in Birjand. Materials and Methods: Descriptive cross- sectional and 50 dialysis patients six months after they started dialysis were selected. The questionnaire measured individual data and recorded the weight before and after dialysis and blood urea before and after dialysis within a minute of slow blood to 50 ml of blood from the patient's body and back venus. Then, measured URR and Kt/V, the distribution of patients in three part low, moderate and high adequacy of dialysis. Statistical analysis were used by descriptive statistics and SPSS software. Results: The mean age were ± years, weight before dialysis 58.2 ± and after hemodialysis 56.2 ± kg, mean BMI 21.40, urea before dialysis was ± 37.92, urea after dialysis was ± mg dl. 70 percent of patients was Kt/V and 66 percent URR between 61 and 70 percent that had a relatively good level of adequacy of dialysis. mean total Kt/V of patients were 1.17 and URR 62.8 percent. Between BMI, the average pump blood, sex patients and the number of time of dialysis at week with dialysis adequacy were significant relationship (P < 0.05). Conclusion: Prevention of ESRD at the community level and attention to details such as the choise strategy to increase hours of dialysis, filter type and time of dialysis at week is important in dialysis wards. Keywords: Hemodialysis, Kt / V, URR, Blood urea, Dialysis adequacy. Journal of Birjand University of Medical Sciences. 2010; 17(3): 214. Received: Last Received: Accepted: Online Version: Correspondin Author; Instructor, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran. 2 Instructor, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran. 3 Supervisor, Department of Hemodiyaliz, Birjand University of Medical Sciences, Birjand, Iran. 4 Nurse, Department of Hemodiyaliz, Birjand University of Medical Sciences, Birjand, Iran. 214