Residual Renal Function Benefits Hemodialysis Patients

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SAN DIEGO—Hemodialysis (HD) patients who have residual kidney function (RKF) have lower serum phosphate levels that those without RKF, a study showed.

In addition, the dose requirements of erythropoietin stimulating agents are up to 50% lower in patients with RKF than in anuric patients, researchers found.

The study, by E. Lars Penne, MD, of Vrije Universiteit Medical Center in Amsterdam, the Netherlands, and colleagues, included 569 chronic HD patients. Investigators divided patients in four groups based on glomerular filtration rate (GFR, expressed as mL/min/1.73 m2).

Overall, a higher GFR was associated with lower mean phosphate levels. Mean phosphate levels were 5.17, 5.54, 5.0, and 4.8 mg/dL for patients with a GFR of 0, up to 1.65, 1.66-4.13, and more than 4.13, respectively.

Additionally, the proportion of patients with serum phosphate levels within treatment targets (more than 3.5 but not more than 5.5 mg/dL) was more than 50% and 60% among patients with a GFR of 1.66-4.13 and higher than 4.13, respectively, compared with about 45% for patients with a GFR of 0-1.65.

The study also showed that patients with the highest RKF had the lowest requirements for phosphate binders.

“Strategies to preserve RKF in HD patients should be encouraged,” the authors concluded.

They reported findings here at the American Society of Nephrology's Renal Week conference.

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