engleski

RISK FACTORS FOR LOSS OF RESIDUAL RENAL FUNCTION IN PATIENTS TREATED WITH CHRONIC HAEMODAYLSIS

BACKGROUND/AIM: Outcome studies suggest that residual renal function (RRF) is a more important determinant of patient survival, morbidity, and quality of life than the prescribed or achieved dialysis dose. The aim of this analysis was to investigate which clinical and laboratory parameters are associated with residual diuresis. METHODS: We analysed 418 (242 male) chronic haemodialysis (HD) patients mean age 67.7 ±13.1 years from five dialyses centres. The mean duration of renal replacement therapy (RRT) was 55.9 ±64 months, while the most commons etiologies of chronic kidney disease were arterial hypertension (30%) and chronic glomerulonephritis (24%). Of 417 analysed patients, 147 (35%) were anuric, while 256 of them had daily urine output of less than 500 ml per day. RESULTS: We didn’t find any significant correlation among residual diuresis and gender, systolic blood pressure (SKT) before the start of HD treatment, as well as SKT at the end of HD procedures and patients dry weight (p=NS). Among investigated laboratory tests (haemoglobin, urea, serum creatinine, potassium, sodium and albumins, as well as C-reactive protein), only serum potassium (r= -0.179 ; p=0.0003) and serum creatinine (r= -0.203 ; p<0.0001) have shown significant negative correlation with residual diuresis. Additionally, age of patients (r= -0.100 ; p=0.05), duration of RRT (r= -0.381 ; p<0.0001), weekly intradialytic yield (r= -0.326 ; p<0.0001) and hypotensive episodes during HD procedures (r= -0.112 ; p=0.023) were showed significant negatively correlation with residual diuresis. On the other hand, diuretics use (r=0.489 ; p<0.0001), daily diuretic dose (r=0.302 ; p<0.0001), as well as diastolic blood pressure (DKT) before the start of HD treatment (r=0.208 ; p<0.0001) and DKT after HD procedures (r=0.113 ; p=0.02) have shown significant positive correlation with residual diuresis. CONCLUSION: The length of dialysis treatment, use of diuretics and weekly intradialytic yield, as well as DKT after haemodialysis, and especially DKT before the start of dialysis treatment were significantly associated with preserved renal function.

RESIDUAL RENAL FUNCTION; CHRONIC HAEMODAYLSIS

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