Choice of dialysis membrane does not influence the outcome of residual renal function in haemodialysis patients

Abstract

It has been recently proposed that haemodialysis membrane choice may influence the maintenance of residual renal function. The aim of the present study was to prospectively analyse the effect of membrane choice on the outcome of renal function in patients entering a chronic haemodialysis programme. Twenty-two patients from four hospitals have been randomly assigned to be dialysed with either polysulphone (PSF)/polyacrylonitrile (PAN) (group A; n = 9), or cuprophane membranes (group B; n = 13). Basal and monthly serum biochemistry, residual creatinine clearance (Ccr) and urine volume (Vu), pharmacological and dialytic treatment, diet, and haemodialysis-related complications were recorded. A significant decrease was observed in the two most relevant variables, i.e. remnant Ccr and Vu, within 3 months of starting haemodialysis, with stabilization during the further follow-up. Such decrease was similar (P NS) for both groups A and B throughout the 9-month observation period. In conclusion, our results suggest that the choice of haemodialysis membrane does not influence the outcome of the residual renal function. Renal function decreased significantly within 3 months on haemodialysis, independently of the type of dialyser membrane.

Clinical Benefit of Preserving Residual Renal Function in Patients after Initiation of Dialysis

“…Caramelo et al [9] randomly assigned 22 patients initiating HD to either highflux polysulfone or PAN membranes or cuprophane. RRF decreased to a similar extent in both groups over the 9-month study period.…”

Residual renal function and nutrition in young patients on chronic hemodialysis

“…Finally, our results stress that RRF should be frequently checked in chronic HD young patients and that an effort to preserve it should be made in these patients [44][45][46][47][48][49][50][51]. The NKF/DOQI guidelines for preservation of RRF provide a number of recommendations to avoid nephrotoxic agents and improve the biocompatibility of the dialysis treatment [52].…”

Hemodialysis Membrane Biocompatibility - Does It Matter?

“…Improved preservation of residual renal function was also observed in 50 patients treated with polysulfone dialysers compared with a retrospective disease-and time-matched population of hemodialysis patients using cellulose acetate dialysers (5). In another study of 22 patients who were randomly assigned to be dialysed with either the biocompatible polysulfone and polyacrylonitrile membranes, or the bioincompatible cuprophane membranes, no significant differences in residual renal function or urine volume over a period of nine months were observed (6). The patients in this study had, however, different primary renal diseases and a higher incidence of hypertension.…”