Residual daily urine volume association with inflammation and nutrition status in maintenance hemodialysis patients.
BACKGROUND
This study determines the clinical significance of residual renal function (RRF), defined as residual daily urine volume (RDUV), in maintenance hemodialysis (MHD) patients.


METHODS
This multi-center study enrolled 704 MHD patients. Geographic, hematological, biochemical, and dialysis-related data were obtained. Values for nutritional and inflammatory markers were analyzed together with RDUV.


RESULTS
In total, 670 of 704 patients (95.2%) with HD duration greater than 1 year had abnormal RDUV (<500 ml). Patients with higher RRF were younger, had shorter HD duration, higher prevalence of hypertension and levels of serum albumin, high density lipoprotein (HDL), and lower mid-week inter-dialysis body weight increase (MIBWI), cardio-thoracic ratio, levels of intact parathyroid hormone, high sensitivity C-reactive protein (Hs CRP), and KT/V (Daugirdes) values than those with low RRF. Stepwise multiple regression analysis demonstrated that RRF was positively correlated with serum albumin, HDL levels, and presence of hypertension, and negatively correlated with age, HD duration, and MIBWI in MHD patients. Moreover, after adjusting factors that were significantly related to serum albumin or Hs CRP, RRF was still positively correlated with serum albumin (0.000137 +/- 0.000585, p = 0.0197) and negatively correlated with log Hs CRP (-0.000184 +/- 0.000952, p = 0.0533). A one-liter increase in RDUV was associated with a 1.4 g/L increase in serum albumin level in MHD patients.


CONCLUSIONS
This clinical study first demonstrated that RRF affects nutritional and inflammatory status in MHD patients. Because malnutrition and inflammation can cause high mortality in MHD patients, preserving RRF is important for these patients.
Department of Internal Medicine, Nan Man General Hospital, Hsinchu City, Taiwan.
Po-Yi
PY
Yang
Ja-Liang
JL
Lin
Dan-Tzu
DT
Lin-Tan
Ching-Wei
CW
Hsu
Tzung-Hai
TH
Yen
Kuan-Hsing
KH
Chen
Tai-Chin
TC
Ho
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D007677:Kidney Function Tests; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D009752:Nutritional Status; D011336:Probability; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D015996:Survival Rate; D013997:Time Factors; D016055:Urinary Retention / Q000175:diagnosis* / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology; D014554:Urination / Q000502:physiology; D055815:Young Adult
D018836:Inflammation Mediators; D002097:C-Reactive Protein