Impact of Residual Kidney Function on Mineral Bone Disorders in Hemodialysis Patients

摘要

Previous studies have demonstrated that mineral bone disorders are major complications of end stage renal disease patients on regular hemodialysis. Residual kidney function could affect severity of complications of hemodialysis and bone biomarkers. We hypothesized that preservation of residual kidney function may have impact on bone mineral disorders in chronic hemodialysis patients. Methods: The study was done on 100 patients on regular hemodialysis, three sessions per week, in dialysis unit of Shebin ElKom Teaching Hospital. Patients were divided into three groups according to urine output (UOP) in 24 hours, group 1 (UOP > 50 ml 24h), group 2 (0 < UOP < 50 ml 24h), group 3 (no UOP) and we measured corrected calcium, phosphorus, iPTH, hemoglobin level and calculated KTV per session then compared these parameters with residual kidney function (RKF) which was calculated by Daugirdas method. Residual kidney function (K ru) =(UUN÷SUN)×urine flow rate (mlmin) (Handbook of Dialysis, 5th edition, 2015). Results: All three groups were compared regarding corrected Ca, phosphorus, iPTH, hemoglobin level, Kt and residual kidney function. There was a significant difference between three groups regarding hemoglobin level, kt, corrected Ca, iPTH and residual kidney function with P value (0.006), (0.001), (0.001), (0.032) and (0.001) respectively, on the other hand, there was no significant difference between three groups regarding phosphorus with P value (0.838). Conclusion: Residual kidney function is an important tool to assess remaining of kidney function and may improve bone mineral disorders if it is preserved, but still the phosphorus out of its control and may be affected by other factors need to be more studied.