Loss of Residual Renal Function in Patients on Regular Haemodialysis

1989 ◽  
Vol 12 (3) ◽  
pp. 159-164 ◽  
Author(s):  
C.G. Iest ◽  
R.C. Vanholder ◽  
S.M. Ringoir
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Residual Renal Function ◽  
Glomerular Disease ◽  
Chronic Haemodialysis ◽  
Dialysis Therapy ◽  
Progressive Loss ◽  
Interstitial Disease ◽  
Haemodialysis Treatment ◽  
Age And Sex

The literature offers scant data on loss of residual renal function in chronic haemodialysis patients. The present study was undertaken in 34 patients, to evaluate residual creatinine clearances (CCr) before the start of haemodialysis and after 3, 12 and 24 months. CCr progressively declined from 6.15± 2.61 (before) to 1.40± 1.29 ml.min–1 (after 24 months: p<0.01). The decrease was largest during the first three months of dialysis therapy (slope - 0.99± 1.01 ml.min–1. month-–1 for the first three months vs. – 0.23± 0.12 ml.min–1. month–1 for the entire 24-month period: p<0.01). The decline in Ccr during the first three months was significantly more pronounced in glomerular disease than in tubulo-interstitial disease (p<0.05). This could not be attributed to differences in blood pressure, body weight or hypotensive medications. Age and sex also had no influence. Our data indicate that there is a characteristic progressive loss of renal function in haemodialyzed patients and that the early decline is most pronounced in patients with glomerular disease. Regular assessment of residual renal function at least every three months is indicated in patients starting chronic haemodialysis treatment.

Risk Factors for Early Mortality in U.S. Peritoneal Dialysis Patients: Impact of Residual Renal Function

2002 ◽  
Vol 22 (3) ◽  
pp. 371-379 ◽  
Author(s):  
◽  
Michael V. Rocco ◽  
Diane L. Frankenfield ◽  
Barbara Prowant ◽  
Pamela Frederick ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Creatinine Clearance ◽  
Residual Renal Function ◽  
Chronic Peritoneal Dialysis ◽  
Dialysis Patients ◽  
The Mean

Background Potential risk factors for 1-year mortality, including the peritoneal component of dialysis dose, residual renal function, demographic data, hematocrit, serum albumin, dialysate-to-plasma creatinine ratio, and blood pressure, were examined in a national cohort of peritoneal dialysis patients randomly selected for the Centers for Medicare and Medicaid Services End-Stage Renal Disease (ESRD) Core Indicators Project. Methods The study involved retrospective analysis of a cohort of 1219 patients receiving chronic peritoneal dialysis who were alive on December 31, 1996. Results During the 1-year follow-up period, 275 patients were censored and 200 non censored patients died. Among the 763 patients who had at least one calculable adequacy measure, the mean [± standard deviation (SD)] weekly Kt/V urea was 2.16 ± 0.61 and the mean weekly creatinine clearance was 66.1 ± 24.4 L/1.73 m2. Excluding the 365 patients who were anuric, the mean (±SD) urinary weekly Kt/V urea was 0.64 ± 0.52 (median: 0.51) and the mean (±SD) urinary weekly creatinine clearance was 31.0 ± 23.3 L/1.73 m2 (median: 26.3 L/1.73 m2). By Cox proportional hazard modeling, lower quartiles of renal Kt/V urea were predictive of 1-year mortality; lower quartiles of renal creatinine clearance were of borderline significance for predicting 1-year mortality. The dialysate component of neither the weekly creatinine clearance nor the weekly Kt/V urea were predictive of 1-year mortality. Other predictors of 1-year mortality ( p < 0.01) included lower serum albumin level, older age, and the presence of diabetes mellitus as the cause of ESRD, and, for the creatinine clearance model only, lower diastolic blood pressure. Conclusion Residual renal function is an important predictor of 1-year mortality in chronic peritoneal dialysis patients.

Effects of Preexistent Hypertension on Blood Pressure and Residual Renal Function After Donor Nephrectomy

2012 ◽  
Vol 93 (4) ◽  
pp. 412-417 ◽  
Author(s):  
Hilde Tent ◽  
Jan-Stephan F. Sanders ◽  
Mieneke Rook ◽  
H. Sijbrand Hofker ◽  
Rutger J. Ploeg ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Residual Renal Function ◽  
Donor Nephrectomy

scholarly journals Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Xiao-dong Xu ◽  
Xue Han ◽  
Yi Yang ◽  
Xu Li
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Peritoneal Dialysis ◽  
Comparative Study ◽  
Systolic Pressure ◽  
Residual Renal Function ◽  
Creative Commons ◽  
Significant Difference ◽  
End Stage

Objective: Diabetic nephropathy is a serious threat to human health, and its incidence is on the rise. End-stage diabetic nephropathy (ESDN) requires extra investigation due to its complexity and severity, as well as serious concurrent diseases. Our objective was to compare the efficacy of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of ESDN. Methods: Clinical data of 84 patients with ESDN admitted to our hospital from June 2016 to June 2018 were retrospectively analyzed. The patients were divided into an HD group that received hemodialysis and a PD group that received peritoneal dialysis. Their general conditions, biochemical indicators, residual renal function and incidence of complications were recorded and compared between the two groups. Results: (1) No significant difference in diastolic blood pressure, systolic blood pressure, body weight, or urine output was detected between the two groups at the beginning of dialysis (P>0.05). (2) Compared to the PD group, the HD group had significantly lower total cholesterol (TC) and triglyceride (TG) (P<0.05), and significantly higher total protein (TP) and albumin (ALB) after treatment (P<0.05). (3) The two groups also showed significant difference in residual renal function after treatment (P<0.05). (4) The HD group had significantly higher systolic pressure than the PD group after treatment (P<0.05). And more cases of infection were observed in the PD group than the HD group (P<0.05). Conclusion: Both HD and PD are used for treatment of ESDN, and can achieve similar calcium and phosphorus control. Compared to HD, PD has less adverse effect on hemodynamics and better preserves residual renal function, but is more likely to cause malnutrition and disorders of lipid metabolism. Therefore, choice of dialysis method should be based on specific conditions of each patient. doi: https://doi.org/10.12669/pjms.36.7.2901 How to cite this:Xu XD, Han X, Yang Y, Li X. Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2901 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The contribution of residual renal function to overall nutritional status in chronic haemodialysis patients

2000 ◽  
Vol 15 (3) ◽  
pp. 396-401 ◽  
Author(s):  
Takeshi Suda ◽  
Kinya Hiroshige ◽  
Takayuki Ohta ◽  
Yujiro Watanabe ◽  
Masako Iwamoto ◽  
...  
Keyword(s):  
Renal Function ◽  
Nutritional Status ◽  
Residual Renal Function ◽  
Chronic Haemodialysis

Risk Factors Influencing the Decline of Residual Renal Function in Continuous Ambulatory Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Sug Kyun Shin ◽  
Hyunjin Noh ◽  
Shin Wook Kang ◽  
Bo Jung Seo ◽  
In Hee Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Renal Function ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Independent Risk Factor ◽  
Residual Renal Function ◽  
Logarithmic Scale ◽  
Linear Scale ◽  
Factors Influencing

Objective To assess the nature of the decline in residual renal function (RRF) after the initiation of peritoneal dialysis, and to identify risk factors influencing the preservation of RRF. Design A retrospective single-center study. Setting Tertiary medical center. Patients Eighty patients who were clinically stable and had been on continuous ambulatory peritoneal dialysis (CAPD) for a minimum of 6 months. Main Outcome Measures All subjects had at least three measurements of RRF, which was calculated as the average of creatinine clearance (Ccr) and urea clearance from a 24-hour urine collection. All measurements of RRF were plotted on a logarithmic scale and a linear scale against the duration of CAPD. Covariables used in the correlation analyses were age, sex, the presence of diabetes mellitus, mean blood pressure, mean diastolic blood pressure, hematocrit and Ccr at the start of peritoneal dialysis, peritoneal membrane transport characteristics by peritoneal equilibration test (PET), and the rate of peritonitis. Results A significant correlation was found between CAPD duration and RRF decline represented on a logarithmic scale with a correlation coefficient ( r) of 0.355 ( p < 0.001). In contrast, on a linear scale, the correlation coefficient was only 0.273 ( p < 0.01). By linear multiple regression analysis, the only independent risk factor for the decline of RRF was the rate of peritonitis ( r = -0.446, p < 0.001). Conclusion These results suggest that RRF declines exponentially rather than linearly with time, and that the rate of peritonitis is an independent risk factor for the decline of RRF in CAPD patients.

scholarly journals Pharmacokinetic and Dynamic of Furosemide in Peritoneal Dialysis Patients

2016 ◽  
Vol 36 (1) ◽  
pp. 107-108 ◽  
Author(s):  
Caroline Lamarche ◽  
Maude Pichette ◽  
Denis Ouimet ◽  
Michel Vallée ◽  
Robert Bell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Pressure Effect ◽  
Urine Volume ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Blood Pressure Effect ◽  
Health Canada

The aim of our study was to evaluate the efficacy and bioavailibility of a commonly used oral furosemide dose (500 mg) compared to a 250 mg intravenous (IV) dose in PD patients with significant residual renal function (urine volume > 100 mL). We also evaluated the immediate blood pressure effect in these patients. The data were obtained from a study we performed for the homologation of a 500-mg dose of furosemide by Health Canada.

scholarly journals Effect of N-Acetylcysteine on Residual Renal Function in Chronic Haemodialysis Patients Treated with High-Flux Synthetic Dialysis Membranes: A Pilot Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Leonid Feldman ◽  
Ramzia Abu Hamad ◽  
Shai Efrati ◽  
Ali Ashker ◽  
Ilia Beberashvili ◽  
...  
Keyword(s):  
Renal Function ◽  
Treatment Group ◽  
Residual Renal Function ◽  
Favorable Effect ◽  
Control Group ◽  
Chronic Haemodialysis ◽  
High Flux ◽  
Combined Use ◽  
Major Predictor ◽  
Dialysis Membranes

Background. Preservation of residual renal function in chronic dialysis patients has proven to be a major predictor of survival. The aim of the present study was to investigate an ability of the combined use of N-acetylcysteine and high-flux biocompatible haemodialysis membranes to improve residual renal function in haemodialysis patients. Patients and Methods. Chronic haemodialysis patients with a residual urine output of at least 100 mL/24 h were administered oral an N-acetylcysteine 1200 mg twice daily for 2 weeks. Treatment group included patients treated with dialysers using high-flux synthetic biocompatible membranes. Control group included patients treated with dialysers using low-flux semisyntetic triacetate haemodialysis membranes. Results. Eighteen patients participated in the study. The residual glomerular filtration rate showed a nonsignificant trend for increase in both groups. The magnitude of GFR improvement after N-acetylcysteine administration was less pronounced in the group treated with high-flux biocompatible membranes: +0.17 ± 0.56 mL/min/1.73 m2 in treatment group and +0.65 ± 0.53 mL/min/1.73 m2 in control group (P<0.05). Conclusion. In this study of favorable effect of N-acetylcysteine on residual renal function in chronic haemodialysis patients may be less pronounced when using high-flux biocompatible, rather than low-flux semisyntetic, HD membranes.

Interplay of volume, blood pressure, organ ischemia, residual renal function, and diet: certainties and uncertainties with dialytic management

2017 ◽  
Vol 30 (5) ◽  
pp. 420-429 ◽  
Author(s):  
Ercan Ok ◽  
Nathan W. Levin ◽  
Gulay Asci ◽  
Charles Chazot ◽  
Huseyin Toz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Residual Renal Function ◽  
Volume Blood
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