Interests of Residual Renal Function in Peritoneal Dialysis

Abstract

Background: Decline of Residual renal function (RRF) is commonly observed in dialysis patients. RRF may play a significant role in the treatment adequacy and outcomes of dialysis patients. Several prospective observational and interventional studies have shown that the presence of RRF was associated with an improved outcome and a reduced mortality in dialysis patients. Preserving RRF is an old holistic dream that still remains to date a source of debate among the nephrologists. The aim of our study was to evaluate the impact of preservation of residual renal function in peritoneal dialysis (PD). Methods: The study was retrospective, descriptive and analytical including patients on peritoneal dialysis in the Nephrology Department of Sahloul Hospital in Sousse during the period from 1 December 2006 to 30 June 2014. We noted clinical and biological parameters for patients with and without RRF. The FRR was defined as a residual clearance upper than 1 ml/min. All statistical analysis was performed with SPSS statistical software version 20. For each parameter the mean ± deviation was calculated. The significance of effects was tested using analysis of variance (ANOVA). Values <0.05 were considered significant. Multiple regression analysis was performed in order to investigate the relationship between RRF and various independent variables (age, gender, blood pressure, and etiology of end stage renal disease). Results: During the study period, 48 patients were collected. RRF was found in 71% of patients with PD. Several benefits were demonstrated: better control of anemia (9.2 vs. 8.01 g/dl), better balance of uricemia (303 vs. 393 μmol/l) a better balance of phosphorus (1.4 vs. 1.8 mmol/l) and a lower risk of peritonitis (absence of peritonitis in 71 vs. 30%). Conclusion: The FRR is an important parameter that should be taken into account in our medical care in dialysis. Its protection should therefore be considered and it responds to many factors.