Phosphate Clearance in End Stage Kidney Disease Patients onHemodialysis
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.Published
2024/12/09
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