Tangvoraphonkchai, K;
Davenport, A;
(2017)
Increasing Haemodialytic Clearances as Residual Renal Function Declines: An Incremental Approach.
Blood Purification
, 44
(3)
pp. 217-226.
10.1159/000475458.
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Abstract
Many patients with chronic kidney disease start undergoing thrice-weekly haemodialysis (HD), aiming for an HD sessional dialyzer urea clearance target, irrespective of whether they have residual renal function (RRF). While increasing sessional dialyzer urea clearance above a target of 1.2 has not been shown to improve patient survival, it has been shown that the preservation of RRF improves patient self-reported outcomes and survival. Observational studies have suggested that initiating twice-weekly HD schedules leads to greater preservation of RRF. This has led to the concept of following an incremental approach to initiating HD, steadily increasing the amount of weekly dialyzer clearance as RRF decreases. Incremental dialysis practice requires the regular assessment of RRF to prevent inadequate delivery of dialysis treatment. Once RRF is lost, then the dialysis schedule and modality need to be adjusted to try to increase the middle-sized solute clearance and protein-bound toxins.
| Type: | Article |
|---|---|
| Title: | Increasing Haemodialytic Clearances as Residual Renal Function Declines: An Incremental Approach |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1159/000475458 |
| Publisher version: | http://doi.org/10.1159/000475458 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Haemodialysis, Kt/V, Incremental, Residual renal function |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10053133 |
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