{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:49:14Z","timestamp":1792788554423,"version":"4.5.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Program for the Talents in Science and Education of Wujiang District, Suzhou, China","award":["WWK202225"],"award-info":[{"award-number":["WWK202225"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The dialysis dose, quantified as Kt, is conventionally scaled to the urea distribution volume (V) to calculate the Kt\/V ratio as an indicator of dialysis adequacy. However, the body surface area (BSA) is recognized as a more accurate reflection of metabolic activity compared to V. This study presents evidence supporting the enhanced efficacy of the Kt\/BSA ratio as an indicator of hemodialysis adequacy. The study population comprised 211 individuals undergoing hemodialysis, all of whom had Kt\/V values determined. Body composition was assessed using bioimpedance techniques, and BSA was calculated employing the DuBois and DuBois formula. The ratio of V\/BSA served as the conversion factor to derive Kt\/BSA from the standard Kt\/V. Participants were categorized by gender, and a comparative analysis was performed on dialysis-related parameters alongside body composition indicators. Concurrently, linear regression analysis was applied to Kt\/V and Kt\/BSA, as well as to pairs of V and BSA, to elucidate the relationships among these variables. The average Kt\/V ratio was 1.50 with a standard deviation of 0.28. The Kt\/V ratio was significantly higher in women (P &lt; 0.01). Conversely, the Kt value, when not adjusted for body size, was significantly lower in women (P &lt; 0.01). Upon scaling Kt to BSA to calculate Kt\/BSA, the gender difference in dialysis dose adequacy was no longer statistically significant (P = 0.06). Men exhibited a significantly higher mean V\/BSA ratio. Additionally, women had a slightly higher mean percentage of fat mass (P &lt; 0.01). In contrast, women had a lower mean percentage of muscle mass (P &lt; 0.01). Our findings suggest that the Kt\/V ratio may underestimate the required hemodialysis dose for women. There was no gender difference when Kt scaling to BSA. Consequently, the Kt\/BSA ratio, which accounts for body surface area, may play a significant role in more accurately scaling the hemodialysis dose.<\/jats:p>","DOI":"10.1371\/journal.pone.0311175","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T13:22:59Z","timestamp":1728307379000},"page":"e0311175","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Adjusting dialysis dose (Kt) scaled to Body Surface Area (BSA) could be a more logical approach"],"prefix":"10.1371","volume":"19","author":[{"given":"Wei","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9079-956X","authenticated-orcid":true,"given":"Zhenguo","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5089-2661","authenticated-orcid":true,"given":"Chunyuan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,10,7]]},"reference":[{"key":"pone.0311175.ref001","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1046\/j.1523-1755.2000.07602.x","article-title":"Whither 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