Kt/Vurea is a poor measure of dialysis quality because it combines three unrelated variables into one formula. These variables influence the clinical status of the patient independent of each other. It is impossible to compensate short dialysis duration (t) with the increased clearances of small molecular substances (K), because the tolerance of ultrafiltration depends on the plasma-refilling rate, which has nothing in common with urea clearances. Clinical assessment is the best criterion of dialysis quality. Longer dialysis provides better tolerance of ultrafiltration, less frequent intradialytic hypotensive episodes, better control of blood pressure, and lower mortality.

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