Original Research

Phosphate Clearance in End Stage Kidney Disease Patients onHemodialysis

Memuna Abbas1
Doctors Hospital and Medical center Lahore,
Sidra Saleem2
Lahore General Hospital, Lahore
Zain Rasool1
Doctors Hospital and Medical center Lahore,
Asadullah Mahmood1
Doctors Hospital and Medical center Lahore,
Abeera Mansur1
Doctors Hospital and Medical center Lahore,

✉ Correspondence: Memuna Abbas Email: drmemunaabbas@gmail.com

DOI https://doi.org/10.70302/jpsim.v5i4.2474
Volume: 5, Issue 4 Pages: 729–734 Published: 09 Dec 2024
Received: 15 Feb 2024 Accepted: 02 Nov 2024 Published Online: 09 Dec 2024

Abstract

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.

Methods

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.

Keywords
End stage kidney disease Hemodialysis Phosphate clearance.

How to Cite This Article

Abbas M, Saleem S, Rasool Z, Mahmood A, Mansur A. Phosphate Clearance in End Stage Kidney Disease Patients onHemodialysis. J Pak Soc Intern Med. 2024;5(4):729–734. doi:10.70302/jpsim.v5i4.2474

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2024 Journal of Pakistan Society of Internal Medicine.
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