JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v5i4.2474 jpsim.v5i4.2474 Original Research Phosphate Clearance in End Stage Kidney Disease Patients on Hemodialysis Abbas Memuna drmemunaabbas@gmail.com * Saleem Sidra Rasool Zain Mahmood Asadullah Mansur Abeera Doctors Hospital and Medical center Lahore, Lahore General Hospital, Lahore *Correspondence: Memuna Abbas (drmemunaabbas@gmail.com) 09 12 2024 2024 5 4 729 734 15 02 2024 02 11 2024 Copyright © 2024 The Author(s) 2024 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

To assess the effect of dietary phosphate intake, delivered dialysis dose (Kt/V, online clearance monitoring

(OCM), urea reduction ratio (URR) and total weekly hemodialysis (HD) duration on phosphate levels and other factors

affecting its clearance.

 Methodology

This study was carried out on 34 ESRD patients on maintenance hemodialysis. Patients' characteristics were all

recorded on a pre-designed Questionnaire. Blood samples were collected from the arterial end before connecting the

arterial line and rinsing the puncture needle; specimens after HD were collected from the arterial line at the end of dialysis;

before collection the blood flow rate was reduced to 50 mL/min.

 Results

Out of 34 hemodialysis patients, 41% (14/34) of patients were compliant to thrice weekly hemodialysis. There

were 16 (47.1%) females and 18 (52.9%) males, age ranging from 17 to 87 and mean age of 59.6 years. Mean pre- & post

HD phosphate were 6.01mg/dl and 2.59mg/dl, respectively. There was a significant mean difference in pre- and post

dialysis phosphate levels (p< 0.01). PRR had no significant association with Kt/V, OCM, URR and blood volume passing

through the dialyzer, UF volume, residual urine output, use of phosphate binders or hematocrit. The post-dialysis

phosphate was lower in patients with higher Kt/V, URR and OCM (r = -0.417 p =0.014, r = -0.307 p =0.07,r = -0.295 p = 0.091

respectively). Patients who had a longer weekly time on dialysis had a lower pre-dialysis phosphate levels (r = -0.34, p = 0.049).

 Conclusion

The pre-dialysis phosphate inversely correlated to total weekly dialysis time rather than Kt/V of a single

session, total phosphate intake or dose of phosphate binders. Despite significant removal of phosphate during a single

session of adequate dialysis, noncompliance to the prescribed three times a week dialysis and thus, decreased total weekly

duration of dialysis may be responsible for hyperphosphatemia.

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