Relationship between residual kidney function and symptom burden in haemodialysis patients. Issue 1 (11th February 2021)

• Record Type: Journal Article
• Authors: Kong, Jessica H.; Davies, Matthew R. P.; Mount, Peter F.
• Is Part Of: Internal medicine journal. Volume 51:Issue 1(2021)
• Page Start: 52
• Page End: 61
• Publication Date: 2021-02-11
• Subjects: residual kidney function -- haemodialysis -- uraemic symptom -- β2‐microglobulin -- potassium; Medicine -- Periodicals; 616
• DOI: 10.1111/imj.14775
• Languages: English
• ISSNs: 1444-0903

Abstract

Abstract: Background: Residual kidney function (RKF) has been associated with improved solute clearance and survival in haemodialysis (HD) patients. However, whether RKF impacts symptom burden in HD patients is unknown. Aims: 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. Methods: 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. Results: A total of 90 maintenance HD patients was recruited; 31.9% had KRU ≥1 mL/min/1.73 m 2 . Patients with KRU ≥1 mL/min/1.73 m 2 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, haemoglobin, C‐reactive protein or serum albumin. Conclusion: Higher RKF was significantly associated with fewer symptoms, and lower serum β2 ‐microglobulin and potassium, suggesting that strategies to preserve RKF may be beneficial.