Hemodialysis Patients Benefit from Residual Kidney Function

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Hemodialysis (HD) patients who have residual kidney function (RKF) have lower serum phosphate levels that those without RKF.
  • Dose requirements of erythropoietin stimulating agents are more than 25% lower in patients with RKF than in anuric patients.
  • Strategies to preserve RKF in HD patients should be encouraged, the authors concluded.

Hemodialysis (HD) patients who have residual kidney function (RKF) have lower serum phosphate levels and use less phosphate binders than those without RKF, according to a study presented at ASN's Renal Week 2009.

In addition, the dose requirements of erythropoietin stimulating agents are more than 25% 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, 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. This result was further confirmed by using a multiple regression model adjusting for age, gender, dialysis vintage, serum albumin, nPNA, and phosphate binder use.

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.

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