Kidneys are important organs responsible for filtering blood and producing
urine. By urinating, the kidneys can discharge the metabolic wastes and excess
water from blood. Therefore, the urine output is an important index in
reflecting of the renal function.
The amount of urine output in hemodialysis is equable to fluid that does not
need to be removed by the dialysis machine. Although the remaining GFR may only
be 4 to 5 Ml/ min in patients begun on maintenance hemodialysis, this is
sufficient to make a significant contribution to the removal of the potential
uremic toxins since filtration is continuous. Moreover, the urine output also
helps regulate the fluid and electrolyte balance and may enhance nutritional
status and survivals.
However, with extended period of hemodialysis, their urine output will
decrease gradually and finally evolve into anuria. The decreasing urine output
in hemodialysis is related to the flowing factors.
1. Once the patients start dialysis, a part of metabolic wastes like blood
urea nitrogen (BUN) and creatinine are filtered out of fluid. The concentration
of BUN and creatinine in blood are lower than before so osmotic diuresis may
decline.
2. The patients with End Stage Renal Failure need to remove the excess water
and sodium from body by hemodialysis. If ultrafiltration occurs, it can cause
the effective blood volume to decline rapidly, which is followed by declining in
urine output.
3. Hemodialysis can only clear up the metabolic wastes, but do not have
secretion or regulation functions at all. With the dialysis going on, the
patients’ renal function is still keeping on aggravation.
For patients on hemodialysis, the residual renal function is closely linked
their urine output. Most of the patients may still have much and even normal
urine output when they just start dialysis. The experts point that they should
keep this condition to create favorable environment for improving the survival
rate of the patients.
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