A survey of Kt/V and analysis of influencing factors in hemodialysis patients in northern China: A multicenter cross-sectional study

Aims: To investigate the epidemiological status of the urea clearance index (Kt/V) among hemodialysis patients in Hohhot, Inner Mongolia, China, and to study its associated factors. Methods: This was a cross-sectional study in which clinical and laboratory data were collected from 996 patients in 7 hemodialysis centers. A Kt/V value of ≥ 1.2 was used to evaluate dialysis adequacy. Furthermore, this study employed univariate and multivariate logistic regression analyses to identify and quantify potential factors. A post hoc analysis was conducted to compare the effects of different dialysis membrane materials. Results: The Kt/V target achievement rate is 69.5%. Multivariate analysis shows: the probability of inadequate dialysis in female patients was 8.9% of that in male; overweight and obese were 5.516 and 15.761 times more likely, respectively, to receive inadequate dialysis than were those with a normal BMI; each one-hour reduction in dialysis, a 1 ml/min decrease in blood flow rate, and a 1 mmol/L drop in cholesterol increased the risk of inadequate dialysis by 83.9%, 3%, and 22.8%, respectively; and each additional month of vascular access use reduced the risk by 1%. The dialysis efficacy of a polysulfone‒polyvinylpyrrolidone blend was superior to that of polysulfone, cellulose triacetate, and polyamide. Conclusion: The Kt/V target achievement rate in the Hohhot region was lower than that reported in economically developed regions of China. Single-dialysis session duration, blood flow rate, duration of access use, total cholesterol, and dialysis adequacy were positively correlated. Male patients demonstrate a higher likelihood of dialysis inadequacy compared to females, while overweight and obese individuals are at a significantly elevated risk of failing to achieve dialysis targets.