Is it time to revisit residual renal function in haemodialysis?

Residual renal function (RRF) is not currently emphasized for patients undergoing haemodialysis (HD). The role of RRF is well recognized in the peritoneal dialysis population as studies have clearly demonstrated a survival benefit with preservation of RRF. There is however, data to suggest that RRF is important in HD patients as well. Contemporary HD therapies using high flux biocompatible synthetic dialysers, bicarbonate buffered ultrapure dialysis fluids with ultrafiltration control appear to allow better preservation of RRF. The long held belief that peritoneal dialysis is better at preserving RRF than HD may no longer be true. More robust studies are required to determine the relative importance of RRF in HD and strategies to best preserve this vital asset.