Effects of different dialysis frequencies combined with furosemide on residual kidney function in end-stage renal disease
10.3760/cma.j.cn114798-20250215-00108
- VernacularTitle:不同频次的血液透析联合襻利尿剂对终末期肾病患者残余肾功能的影响
- Author:
Jun LIU
1
;
Quandong BU
1
;
Huifang WANG
1
;
Hang LIU
1
;
Demin XIE
1
;
Xuemei LIU
1
Author Information
1. 青岛大学附属医院肾病科，青岛 266003
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Furosemide;
Kidney failure, chronic;
Incremental hemodialysis;
Residual kidney function
- From:
Chinese Journal of General Practitioners
2025;24(11):1387-1393
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the protective effects of incremental hemodialysis (iHD) combined with furosemide on residual kidney function (RKF) in end-stage renal disease patients who initiate dialysis with preserved RKF.Methods:This was a randomized controlled trial. The patients diagnosed with end-stage renal disease who initiated hemodialysis at the Department of Nephrology, the Affiliated Hospital of Qingdao University from May 2021 to May 2023 were enrolled. The clinical data were collected and analyzed. The patients were randomly assigned to either iHD group (two 4-hour sessions per week or three 3-hour sessions per week, with oral furosemide 40-80 mg twice daily) or the standard HD group (three 4-hour sessions per week, with oral furosemide 40-80 mg twice daily). Differences in clinical characteristics and RKF were assessed between the two groups of patients at 3 months and 6 months, and the differences between the clinical characteristic and the baseline level at 6 months were analyzed, along with the incidence of adverse events.Results:A total of 87 patients met the inclusion and exclusion criteria, of whom 75 completed this study. The mean age was (53.45±12.57) years old, with 37 females (49.33%) and 38 males (50.67%). The patients were assigned to iHD group (39 cases) and standard HD group (36 cases). At 3 months of the trial, compared with standard HD group, the level of serum C-reactive protein was significantly decreased, and the level of eGFR was significantly increased in the iHD group. At 6 months of the trial, the levels of systolic blood pressure, serum β 2-microglobulin, average ultrafiltration volume and C-reactive protein were significantly decreased, and the levels of eGFR, 24-hour urine volume were significantly increased in the iHD group ( P<0.05). The difference in eGFR, urine volume and systolic blood pressure between the iHD group and the baseline level was significantly smaller than that between the standard HD group and the baseline level (all P<0.05). In contrast, the differences in C-reactive protein was significantly greater than that in standard HD group and the baseline level ( P<0.05). At the 3rd, 6th month of the trial, the 24-h urine volumes of iHD group and standard HD group were (955±219) ml/24 h vs. (847±143) ml/24 h, (914±151) ml/24 h vs. (827±124) ml/24 h, showing statistically significant differences ( t=2.510, P=0.014; t=2.729, P=0.008). Adverse events mainly included pulmonary infections (22 cases), fluid overload during the dialysis interval (or more than 5% of the ideal dry weight, 12 cases), heart failure (4R or 4NR grade, 7 cases), hyperkalemia (6 cases), and thrombosis or failure of vascular access (3 cases). The incidence of adverse events did not differ statistically between the two groups ( P>0.05). Conclusion:iHD combined with furosemide helps preserve RKF and maintain urine output within 6 months compared with standard HD in patients with end-stage renal disease.
