ArticleScientific reports2026
Characterization of residual kidney function in chronic hemodialysis patients using plasma metabolomics.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In dialysis, preservation of residual kidney function (RKF) is associated with a favorable prognosis. We aimed to identify differences in plasma metabolites depending on the presence of RKF and to evaluate whether a subset of biomarkers could assist in classifying RKF. A prospective study was conducted among chronic hemodialysis (HD) patients in Geneva, Switzerland. Presence of significant RKF was defined as residual clearance of urea (KRU) ≥ 2 mL/min on 24 h urine collection. A total of 89 a priori selected plasma metabolites were analyzed by liquid chromatography-mass spectrometry. We included 136 patients, 54 with KRU ≥ 2 mL/min (40%) and 82 (60%) with KRU < 2 mL/min. The overall metabolic profile strongly differed between patients with and without significant RKF, despite similar total (residual + dialytic) clearances. Classification based on the metabolic profile achieved a 93% accuracy to predict significant RKF at a 2 mL/min cut-off. A subset of 3 biomarkers allowed RKF classification with 87% accuracy. RKF has a decisive influence on the overall metabolic profile of HD patients, which may partly explain its clinical benefit. This provides a physiological rationale for RKF preservation in incremental HD programs, while a limited subset of metabolites could prove useful in monitoring RKF in this setting.
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