Can residual kidney function affect quality of life and cognitive function in hemodialysis patients?

Elgendy, Asmaa; Abdelsalam, Adel I.; Mansour, M.; Nassar, Mohammed Kamal

doi:10.1186/s12882-022-02892-7

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…Observational studies examining QOL in incremental HD are limited 6,18 and a systematic review and meta-analyses comparing incremental to standard-dose dialysis has not addressed QOL as an outcome. 12 However, better preservation of RKF has been shown to improve health-related-quality-of-life in the HD population, 27 and an incremental approach may support greater RKF. Broader consumer involvement in trial design to enrich key outcomes of interest will further improve HD treatment.…”

Section: Discussionmentioning

confidence: 99%

Australian Workshops on Patients’ Perspectives on Hemodialysis and Incremental Start

Hegerty¹,

Jauré²,

Scholes‐Robertson³

et al. 2023

Kidney International Reports

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Section: Discussionmentioning

confidence: 99%

Australian Workshops on Patients’ Perspectives on Hemodialysis and Incremental Start

Hegerty¹,

Jauré²,

Scholes‐Robertson³

et al. 2023

Kidney International Reports

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“…The patients may get benefi ts from residual renal function, such as control of biochemical parameters, 78 patients in Dialysis unit of Mansoura University Hospitals underwent regular hemodialysis for more than 6 months; the patients with preserved residual renal function had better quality of life and cognitive function [5]. There is a decline in residual renal function in the fi rst year of hemodialysis with the mean urine volume of 1 cc per month, in 2021, in literature review of medical and nursing journals focusing on residual renal function within the fi rst year post hemodialysis initiation, the median baseline and one year after, the urine volume was 900 cc and 650 cc respectively, the furosemide played a major role in lowering the rate of decline, the high urine volume was associated with lower mortality [6].…”

Section: Discussionmentioning

confidence: 99%

Can a Kidney Failure Patient Survive with One to Two Hemodialysis Sessions per Month for More than 5 Years?

Ntabanganyimana¹,

Nishimwe²,

Kyavulikira³

et al. 2023

J Biomed Res Environ Sci

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Background: Kidney failure known as renal failure or Stage 5 CKD or End Stage Renal Diseases is a major problem among kidney diseases worldwide, its incidence and prevalence are rising yearly. The management requires renal replacement therapy, hemodialysis, 3 sessions per week or peritoneal dialysis until the time of renal transplantation. The cost is high in low income countries and is not covered by major medical insurances. Few renal patients are able to afford dialysis and renal transplantation. Case Presentation: A 45-year-old man Butcher, living in rural Rwanda presented with renal failure and Hypertension with history of native medication intake. He remained on chronic maintenance hemodialysis since October 2017, at one to two hemodialysis sessions per month. He preserved quality of life and cognitive function. He is reporting to have more than 1000 cc of urine volume per day. Conclusion: This case demonstrates that suboptimal hemodialysis sessions can help the renal patients to survive when they preserve residual renal functions.

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“…Reducing the frequency of dialysis can potentially reduce the repeated insults to the brain and decrease the rate of cognitive decline. Greater preservation of residual kidney function, as reported in observational studies of incremental dialysis, can potentially preserve the self-reported health quality of life and cognitive assessment scores of older patients treated with haemodialysis [22]. Thus, starting with incremental dialysis may have significant benefits with regard to preventing the rapid cognitive decline reported in studies of elderly patients treated with conventional thriceweekly dialysis schedules.…”

Section: Frequency Of Dialysis: Should Incremental Dialysis Be the Fi...mentioning

confidence: 99%

Dialysis for older adults: why should the targets be different?

Khatri,

Davenport

2024

J Nephrol

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The number of patients aged > 75-years treated by dialysis continues to increase, particularly in developed countries. Haemodialysis is a well-established treatment with national and international clinical guidelines designed to provide patients with optimal treatment. However, these were developed when the dialysis population was younger, and less co-morbid. This change in patient demographics questions whether these guideline targets still apply to older patients. More patients now start dialysis with residual kidney function and could benefit from a less frequent dialysis schedule. Older patients have a lower thirst drive, so lower interdialytic gains, reduced appetite, muscle mass and physical activity would potentially allow starting dialysis with less frequent sessions a practical option. Similarly, patients with residual kidney function and lower metabolic activity may not need to meet current dialyser Kt/Vurea clearance targets to remain healthy. Instead, some elderly patients may be at risk of malnutrition and might need liberalisation of the low salt, potassium and phosphate dietary restrictions, or even additional supplements to ensure adequate protein intake. Although a fistula is the preferred vascular access, a forearm fistula may not be an option due to vascular disease, while a brachial fistula can potentially compromise cardiovascular reserve, so a dialysis catheter becomes the de facto access, especially in patients with limited life expectancy. Thus, clinical guideline targets designed for a younger less co-morbid dialysis population may not be equally applicable to the older patient initiating dialysis, and so a more individualised approach to dialysis prescription and vascular access is required.

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Can residual kidney function affect quality of life and cognitive function in hemodialysis patients?

Cited by 5 publications

References 32 publications

Australian Workshops on Patients’ Perspectives on Hemodialysis and Incremental Start

Australian Workshops on Patients’ Perspectives on Hemodialysis and Incremental Start

Can a Kidney Failure Patient Survive with One to Two Hemodialysis Sessions per Month for More than 5 Years?

Dialysis for older adults: why should the targets be different?

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