الفهرس 
Residual kidney functionOnly 14 pages are availabe for public view
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Abstract
Preserving residual renal function has always been the primary clinical goal for every nephrologist managing patients with chronic kidney disease.
Residual renal function plays an important role in middle molecule clearance. Irrespective of the modality of dialysis, patients with significant residual renal function showed lower ß2- microglobulin than those with no residual renal function.
Indeed, there is now clear evidence that preserving residual renal function remains important after the commencement of dialysis. Residual renal function contributes significantly to the overall health and well-being of dialysis patients. It not only provides small solute clearance but also plays an important role in maintaining fluid balance, and removal of middle molecular uremic toxins. Decline of residual renal function also contributes significantly to anemia in patients on dialysis.
In this study Forty patients on regular hemodialysis at Ahmad Maher teaching hospital divided in to two main groups according to their urine output according to Yi-Chou Chen, et al (2007) who considered patients with estimated urinary volume of more than 100ml/day are to have residual kidney function and those with estimated urinary volume of less than 100ml/day are to have lost their residual kidney function.
(GroupI) Twenty patients without residual kidney function (GroupII) Twenty patients without residual kidney function were subdivided into(Group IIA) patients on regular hemodialysis for less than six months duration, (Group IIB) patients on regular hemodialysis for more than six months duration .
Calculation of the RRF for each patient by using the MDRD, and Cockcroft-gault equation, Calculation of the delivered dose of dialysis for each patient by using single pole Kt/V, CBC and iron profile, serum albumin, ß2- microglobulin, then Statistical analysis was done and revealed the following results:
48h urine output patients show significant difference between group I and II (104.44±38.07ml versus 608.00±332.54 ml ; p value = 0.000). Subgroups IIA, IIB 48h urine output show statistically significant difference (446.00±248.38 ml versus 770.00±336.82 ml;P value = 0.025).
Estimated kidney function (MDRD, Cockcroft-Gault), showed that MDRD significantly lower in group I compared to group II (3.67±0.49 versus 6.65±2.03; P value = 0.000) also Cokcroft-Gault significantly lower in group I compared to group II (7.17±2.15 versus 11.85±4.86; P value = 0.001).
Anemia in group II showed statistically significant higher HB compared to group I (9.60±1.98 versus 5.473±2.0249;P value =0.045).
Volume status showed better fluid balance in group II compared to group I as regard interdialytic weight gain (1.25±1.48 kg versus 2.34±0.06 kg; P value = 0.033).
The study fail to show statistical significance difference between group I and II as regard predialysis β2 microglobulin (31.93±1.30 versus 32.27±1.71 , p value =0.501 ).Even in subgroups IIA,IIB .
So Preservation of residual kidney function in HD patients improved anemia and maintained fluid balance, despite predialysis β2 microglobulin did not show significant difference , The MDRD estimate residual kidney function more accurate than Cockcroft-Gault in HD patients.
The presented study recommends doing the β2 microglobulin on larger scale of HD patients with significant difference in the groups as regard residual kidney function