Evaluation of the adequacy of hemodialysis by determining carbamylated hemoglobin

Objective TO evaluate the adequacy of hemodialysis therapy in uremic patients by determining carbamylated hemoglobin(CarHb). Methods CarHb was measured by high performance liquid chromatography(HPLC) in 36 normal controls,51 non dialysis patients with chronic renal failure and 30 hemodialysis subjects.The correlation between CarHb in hemodialysis group and Kt/V,the urea reduction ratio(URR),the time averaged concentration of urea(TAC urea) and the normalized protein catabolic rate(nPCR) was analysed.CarHb concentration was expressed as μg of carbamyl valine per gram of hemoglobin(μgCV/gHb). Results Compared with CarHb in normal controls(30 0±6 1),CarHb in hemodialysis group significantly increased,but was much lower than in non dialysis uremic patients(102 5±28 9 vs.139 9±52 0).CarHb was greater in those hemodialysis patients with a Kt/V≤1 1 than those with Kt/V of 1 1(135 0±31 0 vs.88 6±12 0),and there was a positive correlation between CarHb and Kt/V and URR.There was a positive correlation between carHb and TACurea.CarHb with nPCR of 1 0 g·kg 1 ·d 1 was significantly greater than with nPCR of ≥1 0 g·kg 1 ·d 1 . Conclusion CarHb is a useful marker for evaluating the adequancy of hemodialysis therapy.