{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:26:05Z","timestamp":1790803565558,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>\n                    In patients with ESRD, residual kidney function (RKF) contributes to achievement of adequate solute clearance. However, few studies have examined RKF in patients on hemodialysis. In a longitudinal cohort of 6538 patients who started maintenance hemodialysis over a 4-year period (January 2007 through December 2010) and had available renal urea clearance (CL\n                    <jats:sub>urea<\/jats:sub>\n                    ) data at baseline and 1 year after hemodialysis initiation, we examined the association of annual change in renal CL\n                    <jats:sub>urea<\/jats:sub>\n                    rate with subsequent survival. The median (interquartile range) baseline value and mean\u00b1SD annual change of CL\n                    <jats:sub>urea<\/jats:sub>\n                    were 3.3 (1.9\u20135.0) and \u22121.1\u00b12.8 ml\/min per 1.73 m\n                    <jats:sup>2<\/jats:sup>\n                    , respectively. Greater CL\n                    <jats:sub>urea<\/jats:sub>\n                    rate 1 year after hemodialysis initiation associated with better survival. Furthermore, we found a gradient association between loss of RKF and all-cause mortality: changes in CL\n                    <jats:sub>urea<\/jats:sub>\n                    rate of \u22126.0 and +3.0 ml\/min per 1.73 m\n                    <jats:sup>2<\/jats:sup>\n                    per year associated with case mix\u2013adjusted hazard ratios (95% confidence intervals) of 2.00 (1.55 to 2.59) and 0. 61 (0.50 to 0.74), respectively (reference: \u22121.5 ml\/min per 1.73 m\n                    <jats:sup>2<\/jats:sup>\n                    per year). These associations remained robust against adjustment for laboratory variables and ultrafiltration rate and were consistent across strata of baseline CL\n                    <jats:sub>urea<\/jats:sub>\n                    , age, sex, race, diabetes status, presence of congestive heart failure, and hemoglobin, serum albumin, and serum phosphorus levels. Sensitivity analyses using urine volume as another index of RKF yielded consistent associations. In conclusion, RKF decline during the first year of dialysis has a graded association with all-cause mortality among incident hemodialysis patients. The clinical benefits of RKF preservation strategies on mortality should be determined.\n                  <\/jats:p>","DOI":"10.1681\/asn.2015101142","type":"journal-article","created":{"date-parts":[[2016,5,11]],"date-time":"2016-05-11T22:50:30Z","timestamp":1463007030000},"page":"3758-3768","source":"Crossref","is-referenced-by-count":151,"title":["Residual Kidney Function Decline and Mortality in Incident Hemodialysis Patients"],"prefix":"10.1681","volume":"27","author":[{"given":"Yoshitsugu","family":"Obi","sequence":"first","affiliation":[{"name":"Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine School of Medicine, Orange, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie M.","family":"Rhee","sequence":"additional","affiliation":[{"name":"Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine School of Medicine, Orange, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna T.","family":"Mathew","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Northwell Health System, Great Neck, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurang","family":"Shah","sequence":"additional","affiliation":[{"name":"Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine School of Medicine, Orange, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elani","family":"Streja","sequence":"additional","affiliation":[{"name":"Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine School of Medicine, Orange, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Brunelli","sequence":"additional","affiliation":[{"name":"DaVita Clinical Research, Minneapolis, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba P.","family":"Kovesdy","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee;"},{"name":"Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajnish","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"Kidney Research Institute and Harborview Medical Center, Division of Nephrology, University of Washington, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamyar","family":"Kalantar-Zadeh","sequence":"additional","affiliation":[{"name":"Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine School of Medicine, Orange, California;"},{"name":"Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; and"},{"name":"Los Angeles Biomedical Research Institute, Harbor\u2013University of California, Los Angeles, Torrance, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,5,11]]},"reference":[{"issue":"Suppl 1","key":"B1-20231016","first-page":"S130","article-title":"Clinical practice recommendations for peritoneal dialysis adequacy.","volume":"48","year":"2006","journal-title":"Am J Kidney Dis"},{"issue":"Suppl 1","key":"B2-20231016","first-page":"S2","article-title":"Clinical practice guidelines for hemodialysis adequacy, update 2006.","volume":"48","year":"2006","journal-title":"Am J Kidney Dis"},{"key":"B3-20231016","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1681\/ASN.2005020132","article-title":"Serum beta-2 microglobulin levels predict 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