Effect of Incremental Hemodialysis on Residual Kidney function and other Laboratory parameters In End stage Renal Disease patients starting Dialysis

Abstract

esidual kidney function (RKF) in patients with end-stage renal disease plays a critical role in dialysis adequacy, quality of life, and survival by maintaining fluid and metabolic homeostasis, mitigating mineral abnormalities, optimizing uremic toxin clearance, and sustaining higher production of endogenous vitamin D and erythropoietin. Endogenous clearance conferred by RKF is associated with greater survival than dialysis clearance per se, and at a certain RKF level, higher dialysis dose may not influence clinical outcomes in both peritoneal and hemodialysis patients. Furthermore, randomized controlled trials (RCTs) have shown inconsistent results in terms of clinical benefit of higher dialysis dose or frequency, and they may accelerate RKF decline. So this study aimed to detect the effect of twice – weekly HD on patients starting dialysis regarding laboratory parameters and preservation of kidney function. This prospective cohort study included 30 patients from multiple convienant dialysis units in 10th of Ramadan and Mushtoul Elsouq city to initiate twice-weekly hemodialysis, the patient should meet the first (urine output >600 ml/day) and the last criteria (KRU > 3 ml/minute/1.73m2)d, plus most (five out of nine). Patients were examined for these criteria every month for 3 months.