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We present an observational study to evaluate a progressive schedule of dose of dialysis, starting with 2 HD/week, when the renal clearance of urea was equal to or greater than 2,5 mL/min/1,73 m2and the patient is in a stable clinical situation. From 2006 to 2011, 182 patients started hemodialysis in our center, of which 134 were included in the study. Residual renal function (RRF), Kt/V, eKru, nPCR, hemoglobin, weekly erythropoietin dose, and beta-2-microglobulin were determined at 6, 12, 18, 24, and 30 months after dialysis initiation. Seventy patients (52%) began with the progressive schedule of 2 HD/week and 64 (48%) patients began with the conventional thrice-weekly schedule (3 HD/week). The decline of RRF was lower in the group of 2 HD/week: 0,20 (0,02–0,53) versus 0,50 (0,14–1,08) mL/min/month (median and interquartile range,P=0,009). No relationship was found between the decline rate and the basal RRF. Survival analysis did not show differences between both groups. Our experience demonstrates that patients with higher residual renal function may require less than conventional 3 HD sessions per week at the start of dialysis. Twice-weekly hemodialysis schedule is safe and cost-effective and may have additional benefit in maintaining the residual renal function.

We studied 28 patients with parathyroid hormone (PTH) concentrations >65 pg/ml immediately prior to kidney transplant and who had stable allograft function with serum creatinine <2 mg/dl. After 12-18 months of transplantation, biochemical parameters (including 25-hydroxy- and 1,25-dihydroxy-vitamin D3) were studied. Patients were divided into three groups according to their PTH concentrations. Patients with renal transplant were compared with 50 healthy subjects and 20 patients with primary hyperparathyroidism. The mean 1,25-dihydroxy-vitamin D3 concentration of the transplant patients did not differ from the controls, but was lower than in patients with primary hyperparathyroidism. Using univariate linear regression analysis, 1,25-dihydroxy vitamin D3 correlated positively with PTH (P=0.008) and serum calcium (P=0.0015), and inversely with creatinine clearance (P=0.01). However, it did not correlate significantly with serum phosphorus. Our data suggest that renal transplant recipients may have an inappropriate production of 1,25-dihydroxy vitamin D3; suboptimal allograft function may be a major limiting factor.

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Introduction and Aims: RB is an essential percutaneous technique in Nephrology that entails major and minor complications, one being the AVF which is usually asymptomatic and underdiagnosed because of the absence of routine Doppler examination post RB. The aim of our study was to analyze the natural history of asymptomatic AVF post RB of native kidney (NK) and transplanted (RT) detected by Doppler examination following RB