Abstract
Introduction We hypothesized that at least half of incident hemodialysis (HD) patients on 3-times weekly dialysis could safely start on an incremental, 2-times weekly HD schedule if residual kidney function (RKF) had been considered. Methods RKF is assessed in all our HD patients. This single-center, retrospective cohort study of incident adult HD patients, who survived ≥6 months on a 3-times weekly HD regimen and had a timed urine collection within 3 months of starting HD, assessed each patient's theoretical ability to achieve adequate urea clearance, ultrafiltration rate, and hemodynamic stability if on 2-times weekly HD. Results Of the 410 patients in the cohort, we found that 112 (27%) could have optimally and 107 (26%) could have been appropriately considered for 2-times weekly incremental HD. In general, diuretics were underutilized in >50% of subjects who had adequate RKF urea clearance. The optimal 2-times weekly patients had better potassium and phosphorus control. The correlation coefficient of calculated residual kidney urea clearance with 24-hour urine volume and with kinetic model residual kidney clearance was 0.68 and 0.99, respectively. Discussion More than 50% of incident HD patients with RKF have adequate kidney urea clearance to be considered for 2-times weekly HD. When additionally ultrafiltration volume and blood pressure stability are taken into account, more than one-fourth of the total cohort could optimally start HD in an incremental fashion.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 933-942 |
| Number of pages | 10 |
| Journal | Kidney International Reports |
| Volume | 2 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2017 |
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Keywords
- hemodialysis
- incremental hemodialysis
- residual renal function
ASJC Scopus subject areas
- Nephrology
Cite this
Feasibility of Incremental 2-Times Weekly Hemodialysis in Incident Patients With Residual Kidney Function. / Chin, Andrew I; Appasamy, Suresh; Carey, Robert J.; Madan, Niti.
In: Kidney International Reports, Vol. 2, No. 5, 01.09.2017, p. 933-942.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Feasibility of Incremental 2-Times Weekly Hemodialysis in Incident Patients With Residual Kidney Function
AU - Chin, Andrew I
AU - Appasamy, Suresh
AU - Carey, Robert J.
AU - Madan, Niti
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Introduction We hypothesized that at least half of incident hemodialysis (HD) patients on 3-times weekly dialysis could safely start on an incremental, 2-times weekly HD schedule if residual kidney function (RKF) had been considered. Methods RKF is assessed in all our HD patients. This single-center, retrospective cohort study of incident adult HD patients, who survived ≥6 months on a 3-times weekly HD regimen and had a timed urine collection within 3 months of starting HD, assessed each patient's theoretical ability to achieve adequate urea clearance, ultrafiltration rate, and hemodynamic stability if on 2-times weekly HD. Results Of the 410 patients in the cohort, we found that 112 (27%) could have optimally and 107 (26%) could have been appropriately considered for 2-times weekly incremental HD. In general, diuretics were underutilized in >50% of subjects who had adequate RKF urea clearance. The optimal 2-times weekly patients had better potassium and phosphorus control. The correlation coefficient of calculated residual kidney urea clearance with 24-hour urine volume and with kinetic model residual kidney clearance was 0.68 and 0.99, respectively. Discussion More than 50% of incident HD patients with RKF have adequate kidney urea clearance to be considered for 2-times weekly HD. When additionally ultrafiltration volume and blood pressure stability are taken into account, more than one-fourth of the total cohort could optimally start HD in an incremental fashion.
AB - Introduction We hypothesized that at least half of incident hemodialysis (HD) patients on 3-times weekly dialysis could safely start on an incremental, 2-times weekly HD schedule if residual kidney function (RKF) had been considered. Methods RKF is assessed in all our HD patients. This single-center, retrospective cohort study of incident adult HD patients, who survived ≥6 months on a 3-times weekly HD regimen and had a timed urine collection within 3 months of starting HD, assessed each patient's theoretical ability to achieve adequate urea clearance, ultrafiltration rate, and hemodynamic stability if on 2-times weekly HD. Results Of the 410 patients in the cohort, we found that 112 (27%) could have optimally and 107 (26%) could have been appropriately considered for 2-times weekly incremental HD. In general, diuretics were underutilized in >50% of subjects who had adequate RKF urea clearance. The optimal 2-times weekly patients had better potassium and phosphorus control. The correlation coefficient of calculated residual kidney urea clearance with 24-hour urine volume and with kinetic model residual kidney clearance was 0.68 and 0.99, respectively. Discussion More than 50% of incident HD patients with RKF have adequate kidney urea clearance to be considered for 2-times weekly HD. When additionally ultrafiltration volume and blood pressure stability are taken into account, more than one-fourth of the total cohort could optimally start HD in an incremental fashion.
KW - hemodialysis
KW - incremental hemodialysis
KW - residual renal function
UR - http://www.scopus.com/inward/record.url?scp=85030166194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030166194&partnerID=8YFLogxK
U2 - 10.1016/j.ekir.2017.06.005
DO - 10.1016/j.ekir.2017.06.005
M3 - Article
AN - SCOPUS:85030166194
VL - 2
SP - 933
EP - 942
JO - Kidney International Reports
JF - Kidney International Reports
SN - 2468-0249
IS - 5
ER -