The importance of residual kidney function for patients on dialysis: a critical review.
Increasing the dialysis dose has failed to have an impact on the mortality of dialysis patients. In contrast, residual kidney function (RKF) has consistently been a potent predictor of improved survival for both hemodialysis and peritoneal dialysis patients. The benefits of RKF preservation challenge historical concepts of dialysis adequacy that have focused principally on achieving small-solute clearance targets. In this review, we highlight the evidence supporting the impact of RKF on survival and quality of life of dialysis patients and provide a mechanistic framework for this relationship. Current strategies to preserve RKF also are reviewed, emphasizing those used in patients treated with peritoneal dialysis.
Perl
Jeffrey
J
Division of Nephrology, University Health Network, Toronto, Ontario, Canada.
Bargman
Joanne M
JM
D002986:Clinical Trials as Topic / Q000639:trends; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D007677:Kidney Function Tests / Q000639:trends; D006435:Renal Dialysis / Q000639:trends*