NDT Advance Access originally published online on March 8, 2005
Nephrology Dialysis Transplantation 2005 20(4):671-673; doi:10.1093/ndt/gfh723
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Editorial Comment
The importance of residual renal function for patients on dialysis
Division of Nephrology, 1 University Health Network, University of Toronto, Canada and 2 Vanderbilt University Medical Center, Nashville, TN, USA
Correspondence and offprint requests to: Joanne M. Bargman MD FRCPC, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Email: joanne.bargman@uhn.on.ca
Keywords: adequacy of dialysis; haemodialysis adequacy; peritoneal dialysis
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Introduction |
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It is the goal of every practitioner involved in the care of dialysis patients to maximize survival and quality of life. The last two decades have seen a plethora of investigations that have sought to determine how this goal can be achieved. The bulk of the studies have, unfortunately, concentrated on small solute clearance and outcome (measured principally as mortality). The HEMO [1] and ADEMEX [2] studies suggested that this is not a fruitful avenue of investigation. However, the residual kidney function in patients on dialysis, particularly in those on peritoneal dialysis (PD), has proven to be a consistent and powerful predictor of mortality.
We will review the evidence supporting the importance of residual renal function (RRF) on outcome, propose some explanations as to why this relationship exists, and suggest ways to prolong the renal function in dialysis patients.
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The evidence |
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Maiorca and colleagues were
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Why is RRF important to outcome? |
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Preserving RRF in the dialysis patient |
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