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Published on: July 19, 2018
[Maintaining residual renal function in patients on dialysis]
Jean-Philippe Ryckelynck1, Éric Goffin, Christian Verger
1CHU de Caen, avenue Georges-Clemenceau, 14033 Caen cedex 9, France.
Nephrologie & Therapeutique
|June 18, 2013
Summary
Maintaining renal residual function (RRF) improves survival and quality of life for dialysis patients. Strategies like hemodiafiltration and avoiding hypotension/dehydration are key for preserving RRF.
Area of Science:
- Nephrology
- Renal Medicine
- Dialysis Therapy
Context:
- Renal residual function (RRF) significantly impacts survival and quality of life in dialysis patients.
- Maintaining RRF is a critical clinical goal in managing chronic kidney disease.
- Various strategies exist to preserve RRF during dialysis treatment.
Purpose:
- To review current clinical strategies for maintaining renal residual function (RRF) in dialysis patients.
- To evaluate the impact of different dialysis modalities and interventions on RRF preservation.
- To identify factors deleterious and beneficial for RRF in hemodialysis and peritoneal dialysis.
Summary:
- Hemodiafiltration may offer advantages over conventional hemodialysis for RRF preservation, showing comparable results to peritoneal dialysis.
- Arterial hypotension during hemodialysis and dehydration during peritoneal dialysis negatively affect RRF.
- Loop diuretics do not preserve RRF, while radiocontrast agents and aminoglycosides appear safe. The role of ACE inhibitors and ARBs is debated but may benefit cardiovascular health.
Impact:
- Understanding these factors allows for optimized dialysis strategies to enhance patient outcomes.
- Preserving RRF can lead to improved long-term survival and better quality of life for individuals on dialysis.
- This review provides evidence-based guidance for clinicians managing dialysis patients and aiming to maintain RRF.
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