The Relationship between Residual Kidney Function and Symptom Burden in Hemodialysis Patients.

Abstract

Residual kidney function (RKF) has been associated with improved solute clearance and survival in hemodialysis (HD) patients. However, whether RKF impacts symptom burden in HD patients is unknown. To determine the prevalence of RKF in HD patients and to explore associations between higher levels of RKF with symptom burden, as well as clinical and biochemical parameters. This is a single centre, retrospective, observational study. RKF was assessed as urea clearance (KRU) by interdialytic urine collection. Symptom burden was measured using the palliative care outcome scale renal questionnaire. 90 maintenance HD patients were recruited. 31.9% had KRU ≥1ml/min/1.73m2. Patients with KRU ≥1ml/min/1.73m2 reported fewer symptoms (5.3 ± 3.5 vs 7.7 ± 3.8) (p=0.011), including less shortness of breath (15% vs 55%) (p=0.0013) and vomiting (0% vs 30%) (p=0.0016). Higher RKF was associated with lower β2-microglobilin (p<0.0001), and lower serum potassium (p=0.02), but no difference in phosphate, hemoglobin, C-reactive protein or serum albumin. Higher RKF was significantly associated with fewer symptoms, and lower serum β2-microglobilin and potassium, suggesting that strategies to preserve RKF may be beneficial. This article is protected by copyright. All rights reserved.