• Jessica H Kong, Matthew R P Davies, and Peter F Mount.
• Dentistry and Health Sciences, Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
• Intern Med J. 2021 Jan 1; 51 (1): 52-61.

BackgroundResidual 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.AimsTo 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.MethodsThis 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.ResultsA total of 90 maintenance HD patients was recruited; 31.9% had KRU ≥1 mL/min/1.73 m2 . Patients with KRU ≥1 mL/min/1.73 m2 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.ConclusionHigher RKF was significantly associated with fewer symptoms, and lower serum β2 -microglobulin and potassium, suggesting that strategies to preserve RKF may be beneficial.© 2020 Royal Australasian College of Physicians.

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