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Determining factors of diuresis in chronic kidney disease patients initiating hemodialysis.

Nechita AM, Rădulescu D, Peride I, Niculae A, Bratu O, Ferechide D, Ciocâlteu A, Checheriță IA, Mischianu D - J Med Life (2015 Jul-Sep)

Bottom Line: Glomerular etiology, cardiac systolic dysfunction, severe malnutrition, emergency dialysis initiation and lack of permanent vascular access were proved to be associated with significant low diuresis.Age, gender, estimated glomerular filtration rate (GFR) and the presence of systemic hypertension did not influence the amount of daily diuresis.Factors influencing residual diuresis may be distinct from those that influence residual GFR.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Dialysis, "Sf. Ioan" Clinical Emergency Hospital, Bucharest, Romania.

ABSTRACT

Background: Patients with stage 5 chronic kidney disease (CKD) begin chronic hemodialysis with variable diuresis levels correlated to a comparable low glomerular filtration rate. Residual diuresis influences long-term evolution of the hemodialyzed patient, modifying the prognosis even if optimal Kt/ V is achieved.

Aim of the study: The present study emphasizes the main determining factors of diuresis in a cohort of stage 5 CKD subjects at the beginning of hemodialysis.

Material and methods: 216 patients with stage 5 CKD starting chronic hemodialysis were included in the study, and were grouped according to their residual diuresis: group A (urine output ≤ 500 mL/ day); group B (urine output between 500-1200 mL/ day); group C (urine output ≥ 1200 mL/ day).

Results: Glomerular etiology, cardiac systolic dysfunction, severe malnutrition, emergency dialysis initiation and lack of permanent vascular access were proved to be associated with significant low diuresis. Age, gender, estimated glomerular filtration rate (GFR) and the presence of systemic hypertension did not influence the amount of daily diuresis.

Conclusions: In CKD stage 5 patients, residual diuresis presents large variations in conditions of comparable low GFR. Factors influencing residual diuresis may be distinct from those that influence residual GFR.

No MeSH data available.


Related in: MedlinePlus

Average diuresis volume depending on primary renal diseasesLegends: DN = diabetic nephropathy; GN = glomerular diseases (non-diabetic); CTIN = chronic tubulointerstitial nephropathies; VN = vascular nephropathies; CD = cystic diseases.
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Figure 5: Average diuresis volume depending on primary renal diseasesLegends: DN = diabetic nephropathy; GN = glomerular diseases (non-diabetic); CTIN = chronic tubulointerstitial nephropathies; VN = vascular nephropathies; CD = cystic diseases.

Mentions: Analyzing the primary renal diseases in the three groups, we noted that chronic non-diabetic glomerulopathies, followed by diabetic nephropathies were associated with the lowest urine volumes: average of 282 mL/ day and of 582.76 mL/ day, respectively (T test, p = 0.012). Chronic tubulointerstitial nephropathies were correlated with increased urine output, average 1618.92 mL/ day (T test, p = 0.3506) – Fig. 5.


Determining factors of diuresis in chronic kidney disease patients initiating hemodialysis.

Nechita AM, Rădulescu D, Peride I, Niculae A, Bratu O, Ferechide D, Ciocâlteu A, Checheriță IA, Mischianu D - J Med Life (2015 Jul-Sep)

Average diuresis volume depending on primary renal diseasesLegends: DN = diabetic nephropathy; GN = glomerular diseases (non-diabetic); CTIN = chronic tubulointerstitial nephropathies; VN = vascular nephropathies; CD = cystic diseases.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556923&req=5

Figure 5: Average diuresis volume depending on primary renal diseasesLegends: DN = diabetic nephropathy; GN = glomerular diseases (non-diabetic); CTIN = chronic tubulointerstitial nephropathies; VN = vascular nephropathies; CD = cystic diseases.
Mentions: Analyzing the primary renal diseases in the three groups, we noted that chronic non-diabetic glomerulopathies, followed by diabetic nephropathies were associated with the lowest urine volumes: average of 282 mL/ day and of 582.76 mL/ day, respectively (T test, p = 0.012). Chronic tubulointerstitial nephropathies were correlated with increased urine output, average 1618.92 mL/ day (T test, p = 0.3506) – Fig. 5.

Bottom Line: Glomerular etiology, cardiac systolic dysfunction, severe malnutrition, emergency dialysis initiation and lack of permanent vascular access were proved to be associated with significant low diuresis.Age, gender, estimated glomerular filtration rate (GFR) and the presence of systemic hypertension did not influence the amount of daily diuresis.Factors influencing residual diuresis may be distinct from those that influence residual GFR.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Dialysis, "Sf. Ioan" Clinical Emergency Hospital, Bucharest, Romania.

ABSTRACT

Background: Patients with stage 5 chronic kidney disease (CKD) begin chronic hemodialysis with variable diuresis levels correlated to a comparable low glomerular filtration rate. Residual diuresis influences long-term evolution of the hemodialyzed patient, modifying the prognosis even if optimal Kt/ V is achieved.

Aim of the study: The present study emphasizes the main determining factors of diuresis in a cohort of stage 5 CKD subjects at the beginning of hemodialysis.

Material and methods: 216 patients with stage 5 CKD starting chronic hemodialysis were included in the study, and were grouped according to their residual diuresis: group A (urine output ≤ 500 mL/ day); group B (urine output between 500-1200 mL/ day); group C (urine output ≥ 1200 mL/ day).

Results: Glomerular etiology, cardiac systolic dysfunction, severe malnutrition, emergency dialysis initiation and lack of permanent vascular access were proved to be associated with significant low diuresis. Age, gender, estimated glomerular filtration rate (GFR) and the presence of systemic hypertension did not influence the amount of daily diuresis.

Conclusions: In CKD stage 5 patients, residual diuresis presents large variations in conditions of comparable low GFR. Factors influencing residual diuresis may be distinct from those that influence residual GFR.

No MeSH data available.


Related in: MedlinePlus