A group of researchers from Nagoya University, the University of California, the University of Mississippi, and the University of Tennessee in the United States, in an analysis of kidney disease patients undergoing hemodialysis, found that the lower the residual renal function, the higher the risk of death significantly. It revealed that.
In patients with renal failure, the function of the kidneys decreases, making it impossible to adequately excrete waste products and excess water from the body.If renal replacement therapy such as hemodialysis is not performed, the waste products accumulated in the body can lead to uremia. or heart failure as a result of excessive fluid overloading the heart.With advances in medical technology and dialysis equipment, the prognosis for patients with renal failure has improved, but the five-year survival rate for dialysis patients is still equal to or lower than that of cancer patients suffering from gastric cancer or malignant lymphoma. That's what it means.
In this study, we analyzed the relationship between residual renal function and the risk of cardiovascular and non-cardiovascular mortality, including sudden cardiac death, using data from a large-scale nationwide dialysis patient population.The subjects were approximately 2007 end-stage renal disease patients who newly started hemodialysis between 2011 and 4, and who had low residual renal function (renal urea clearance or daily urine output) at the time they started hemodialysis. Mortality risk was assessed by grouping in order.
As a result, during a median follow-up period of 548 days, there were 2,772 cardiovascular deaths (including 1,905 sudden cardiac deaths) and 2,198 non-cardiovascular deaths, regardless of the cause of death. A higher risk of death was found in the group with lower renal function.In a secondary analysis, we found that the greater the decline in renal function (the faster the rate of loss of daily urine volume) six months after starting dialysis, the higher the risk of sudden cardiac death and non-cardiovascular death.It was also found that patients with low residual renal function tended to have a low standardized protein catabolism rate, which is one of the nutritional indicators.
The results highlight once again how important the role of the kidneys is, as even a small amount of residual kidney function has a significant impact on life expectancy and nutrition.In the future, it can be said that there is a need to develop therapeutic strategies to maintain even a small amount of remaining renal function in patients with renal disease.
Paper information:[Kidney International Reports] Residual Kidney Function and Cause-Specific Mortality among Incident Hemodialysis Patients
