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dc.contributor.authorVilar, Enric
dc.contributor.authorWellsted, D.
dc.contributor.authorChandna, S.M.
dc.contributor.authorGreenwood, R.N.
dc.contributor.authorFarrington, Ken
dc.identifier.citationVilar , E , Wellsted , D , Chandna , S M , Greenwood , R N & Farrington , K 2009 , ' Residual renal function improves outcome in incremental haemodialysis despite reduced dialysis dose ' , Nephrology Dialysis Transplantation , vol. 24 , no. 8 , pp. 2502-2510 .
dc.identifier.otherPURE: 118816
dc.identifier.otherPURE UUID: 417c7537-c738-42df-a251-5b92730cf678
dc.identifier.otherdspace: 2299/3756
dc.identifier.otherScopus: 67651097770
dc.descriptionEnric Vilar, David Wellsted, Shahid M. Chandna, Roger N. Greenwood, Ken Farrington, 'Residual renal function improves outcome in incremental haemodialysis despite reduced dialysis dose', Nephrol Dial Transplant, Vol 24(8): 2502-2510, 2009, the final published version is available online at doi: © 2009 The Author(s). Published by Oxford University Press on behalf of ERA-EDTA.
dc.description.abstractBackground and Methods. The importance of residual renal function is well recognized in peritoneal dialysis but its role in haemodialysis (HD) has received much less attention. We studied 650 incident patients in our incremental high-flux HD programme over a 15-year period. Target total Kt/V urea (dialysis plus residual renal) was 1.2 per session and monitored monthly. Renal urea clearance (KRU) was estimated 1–3 monthly. Results. KRU declined during the first 5 years of HD from 3.1 ± 1.9 at 3 months to 0.9 ± 1.2 ml/min/1.73 m2 at 5 years. The percentage of patients with KRU 1 ml/min at these time points was 85% and 31%, respectively. Patients with KRU 1 ml/min had a significantly lower mean creatinine (all time points), ultrafiltration requirement (all time points) and serum potassium (6, 12, 36 and 48 months). Nutritional parameters were also significantly better in respect to nPCR and serum albumin (6, 12, 24 and 36 months). Patients with KRU 1 ml/min had significantly lower erythropoietin requirements and erythropoietin resistance indices (12, 24, 36 and 48 months). Mortality was significantly lower in patients with a KRU 1 at 6, 12 and 24 months after HD initiation, this benefit being maintained after correcting for albumin, age, comorbidities, HDF use and renal diagnosis. Our unique finding was that these benefits occurred despite those with KRU 1 ml/min having a significantly lower dialysis Kt/V at all time points. Conclusion. The associations demonstrated suggest that residual renal function contributes significantly to outcome in HD patients and that efforts to preserve it are warranted. Comparative outcome studies should be controlled for residual renal function.en
dc.relation.ispartofNephrology Dialysis Transplantation
dc.subjectrenal function
dc.subjectdialysis procedure
dc.subjectserum albumin
dc.titleResidual renal function improves outcome in incremental haemodialysis despite reduced dialysis doseen
dc.contributor.institutionDepartment of Psychology
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionCentre for Lifespan and Chronic Illness Research
dc.description.statusPeer reviewed
rioxxterms.typeJournal Article/Review

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