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Medical Information from the NKF - Know your numbers - Dialysis

 

Introduction

If you have kidney failure, you need regular monitoring by hospital staff. This leads to better treatment. The effectiveness of your treatment can be assessed using the numbers from the many measurements and blood tests that are taken. Knowing your numbers will help you to:

  • Assess for yourself how well your treatment is going
  • Explain some of your symptoms
  • Know if your treatment needs changing
  • Compare your results with national targets

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Who knows their numbers?

The NKF recently did a survey of 1500 members in June 2000 to find out what they knew about one of the numbers, haemoglobin - 26% replied

  • 47% of these had never heard of the national targets for numbers
  • 84% had heard of haemoglobin
  • 67% of these knew their own level
  • 20% had never discussed haemoglobin, anaemia or any other ‘numbers’ with doctors
  • 87% would like a printed leaflet to obtain such information

There is still a long way to go before every patient ‘knows their numbers’. This page is to help you understand all your numbers and enable you to discuss them with hospital staff.

How do I find out my numbers?

You should be told your numbers by hospital staff when you attend for appointment or during a home visit. If not, ask for them. Staff should all be able to discuss your numbers with you.

What if the numbers are outside the normal range?

There are many reasons why one or more of your results may not be within the normal range. It is important that you ask the renal staff to explain to you the reasons why this has happened in your case. Discuss with them the best treatment for you - this will be based on the results of your tests and physical examination and on your individual needs. Don't hesitate to talk to your doctor or the health care team if you have any questions or problems.

Always check the local normal range for the numbers with staff as it may vary between hospitals, and alter the targets for some bloods.

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What numbers are measured?

Haemoglobin (Hb) is the substance in red blood cells which carries oxygen around the body. Too low a level of Hb is known as anaemia. Anaemia causes tiredness, shortness of breath and paleness - it may need treatment with iron or with erythropoietin (EPO) injections.

Calcium and phosphate are the most important minerals in your bones. Levels of calcium and phosphate act like a see-saw - if one rises the other falls. Phosphate rises in renal failure and may cause itching. Calcium tends to fall.

Potassium is a mineral that is normally removed by the kidneys and by dialysis. Too high or low a potassium level may cause a disturbance to the rhythm of your heart.

Bicarbonate: The kidney helps to maintain the balance of acid in the body. In renal failure the body retains too much acid and this causes a low level of bicarbonate in your blood.

Parathyroid Hormone (PTH) becomes very high in renal failure to restore the normal calcium levels. This is one cause of renal bone disease. Phosphate binding tablets (eg Calcichew) and Vitamin D (eg alfacalcidol) help prevent this.

Blood Pressure is the pressure produced by the heart to pump blood around the body. Too high a blood pressure increases the risk of heart attacks and strokes and is treated by blood pressure tablets.

Urea and Creatinine are two of the most important waste products removed by the kidneys. Hospital staff use complicated numbers derived from urea and creatinine numbers to measure dialysis adequacy - URR, KT/V and CC (Creatinine Clearance).

StandardHaemodialysisPeritoneal Dialysis
Haemoglobin 100-120g/l
( in >85% of patients)
100-120g/l
( in >85% of patients)
Calcium Local normal range Local normal range
Phosphate 1.1-1.8 mmol/l 1.1-1.8 mmol/l
Potassium 4.0-6.0 mmol/l 3.3-5.5 mmol/l
Bicarbonate 20-26 mmol/l Local normal range
Parathyroid Hormone (PTH) 2-4 × Upper limit local normal range 2-4 × Upper limit local normal range
Systolic BP ≤140 mmHg ≤130 mmHg
Diastolic BP ≤90 mmHg ≤80 mmHg
Adequacy URR ≥65% or KT/V ≥1.2 CC >501/week or KT/V>1.7 for CAPD
(651/week and >2.0 for APD)
Cholesterol Under 5.0 mmol/L Under 5.0 mmol/L

In 2013 a change has been made to the reporting of haemoglobin from grammes per decilitre to grammes per litre.  This means that a haemoglobin of 10.5 g/dl is now 105 g/l.  So multiply the old haemoglobin level by ten to get the new one.

 

 

How to Download a Continuation Card

To download a Continuation card for printing, you will need Adobe Acrobat Reader installed on your computer. This can be obtained free from the Adobe web site or from the cover CD-ROM of many computer magazines.

To start the download, click on the thumbnail image of the Know Your Numbers Card below. The blank white screen that appears when downloading will be replaced by the form when the download is complete - please be patient (download times are indicated for slow to medium modem speeds).

Instead of opening the Continuation Card in your browser, you can save it to your computer hard disk. To do this, right click on the thumbnail image below and then, on the drop down menu, click on ‘Save Target As’ (Internet Explorer) or ‘Save Link’ (Netscape/Opera).

Picture of Numbers Card

PDF icon100kb (28 secs @ 28.8 Kilobits/second)

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Note: This website also contains ‘Know your Transplant numbers’


The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

NKF Controlled Document No. 182: Know your numbers - Dialysis written: 06/11/2001 last reviewed: 28/08/2015