Evaluation of hemodialysis adequacy using urea reduction rate and related factors in Iranian patients’ undergoing hemodialysis in Guilan, Iran

Introduction: Dialysis quality is an important factor in reducing inability and mortality in chronic kidney failure patients and can enhance their life quality and social activity. Objectives: The aim of this investigation was to examine the efficacy of dialysis based on urea reduction rate (URR) and the associated factors in hemodialysis patients due to the lack of clarity on the adequacy of dialysis. Patients and Methods: This multicenter cross-sectional study was conducted on 344 hemodialysis patients over 18 years and referred to seven dialysis centers in Guilan, Iran. The adequacy of dialysis was obtained using URR (>65%) criteria. Results: The mean URR of studied patients was 63 ±10.4%. The desirable dialysis adequacy was reached in 45.9% of the patients. There was a significant negative association between URR and BMI (r= -0.155, P =0.005). Patients who had normal calcium levels had significantly higher URR adequacy than patients with abnormal calcium levels ( P <0.001). The URR criterion was contrariwise associated to blood pressure before and after dialysis ( P <0.05). There was a significant association between the length of the time, patients underwent dialysis (in year) and URR (R=125, P =0.023). Conclusion: This study indicated that URR is a desirable criterion for dialysis adequacy, which was associated with blood pressure, serum calcium level and body mass index (BMI). These findings suggest providing treatment strategies based on these findings to enhance the effect of dialysis adequacy.