Impact of residual renal function in children on hemodialysis

Residual renal function (RRF) contributes to dialysis adequacy as well as l ower mortality and morbidity in dialysis patients. Even very small changes in glomerular filtration rate (GFR) account for considerable improvements i n complications of dialysis. The purpose of this cross-sectional study is t o determine the possible contribution of RRF to hemodialysis clearance and to compare the biochemical markers of this patient group with anuric patien ts. Ten patients with RRF on chronic hemodialysis for more than 6 months we re enrolled in the study. Duration of dialysis was not different between th e two patient populations. Average GFR was 3.4 +/-2.6 ml/min in the group w ith RRF. Cholesterol, albumin, and triglyceride levels were not different b etween the groups. Residual renal urea clearance enhanced mean Kt/V of pati ents from 1.29 to 1.52. However erythropoietin and renin levels were higher in the group with RRF (P=0.019, P=0.044, respectively). There was a positi ve correlation between erythropoietin, renin levels, and average GFR of all patients (r-0.69, P=0.002, r=0.60, P=0.014). We conclude that RRF plays a greater role in pediatric patients on hemodialysis than previously recogniz ed, and knowledge about patients' RRF should assist in improved overall man agement.