title: The effect of dialyzer membrane and etiology of kidney disease on the preservation of residual renal function in chronic hemodialysis patients.
abstract: It is commonly believed that renal function rapidly decreases in the vast majority of chronic hemodialysis patients. Three hundred thirty-four patients starting chronic hemodialysis between 1/1/88 and 12/31/92 at six hemodialysis units were prospectively studied. Renal function was determined every 3 months by 68 hr urine collection expressed as weekly fraction urea clearance (L/L total body water/wk). glomerular filtration rate was calculated from the mean of the urea and creatinine clearance. After 3 years, glomerular filtration rate exceeded 4 ml/min in 14% of patients. For a thrice weekly dialysis schedule, it was assumed that a weekly fractional urea clearance of 3 L/L/wk is equal to a dialysis KT/V of 1 and patients need a minimum KT/V of 1.2 per treatment. After 3 years of chronic hemodialysis therapy, residual renal function was found to provide 15% of the dialysis requirement in 19% of patients and 30% of the dialysis requirements in 9% of patients. The occasional patient maintains sufficient residual renal function to provide over 40% of the dialysis requirement for over 4 years. In a retrospective analysis, patients treated only with Cupraphan membrane had a more rapid loss of renal function compared to those never treated with Cupraphan (Besnberg Corp., Germany). The majority of patients with polycystic kidney disease maintained a glomerular filtration rate greater than 2 ml/min for 4 years or longer.
authors.affiliation: University of Missouri Medical School, Dialysisi Clinics Inc., Columbia 65201, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Van Stone
mesh_terms: D001672:Biocompatible Materials / Q000009:adverse effects; D002482:Cellulose / Q000009:adverse effects / Q000031:analogs & derivatives; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D007688:Kidneys, Artificial / Q000009:adverse effects; D008567:Membranes, Artificial; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D014508:Urea / Q000378:metabolism
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial; D014508:Urea; D002482:Cellulose; C009865:cuprammonium cellulose