Author Identifier (ORCID)
Lijun Zhong: https://orcid.org/0009-0008-9672-7103
Ulrich Steinwandel: https://orcid.org/0000-0002-8660-0175
Hugh Davies: https://orcid.org/0000-0002-0867-2288
Sara Bayes: https://orcid.org/0000-0001-7121-9593
Abstract
Background: Residual kidney function in patients receiving haemodialysis is associated with improved survival, reduced cardiovascular risk and better quality of life. Yet, clinical guidelines on its preservation are limited, and local practices remain unclear. Objectives: To explore current practices, perceptions and challenges related to residual kidney function preservation among renal clinicians. Design: Descriptive cross-sectional survey. Participants: Renal physicians and nurses working in hospital-based haemodialysis units across Western Australia. Measurements: Role-specific questionnaires were administered to renal physicians and nurses. Results: Eighty-four completed responses were received (physicians n = 25; nurses n = 59). Over half of physicians (56%, n = 14) reported residual kidney function was present in more than half of patients at haemodialysis initiation, while most nurses (64%, n = 30) indicated it was often or always present. Assessment of this function was reported by 64% of physicians (n = 16) and 61% of nurses (n = 36), predominantly via patient self-reported urine output (physician 100%, n = 16; nurses 86%, n = 31). Most physicians (76%, n = 19) and nearly all nurses (90%, n = 53) believed preservation could improve patient outcomes. Key reported challenges included lack of consensus on optimal approaches (physicians 74%, n = 17; nurses 54%, n = 29), absence of clinical guidelines (nurses 61%, n = 33), difficulty in accurate assessment (physicians 65%, n = 15; nurses 52%, n = 28), and limited patient awareness (physician 57%, n = 13). Nurses identified staff education (83% n = 49) and practice guidelines (81%, n = 48) as key enablers to enhancing preservation efforts. Conclusions: While the clinical value of residual kidney function is widely recognised, its preservation in haemodialysis remains constrained by the lack of clinical consensus and guidelines, and limited awareness among patients and clinicians. Clear guidelines and targeted education are essential to integrate preservation practices into routine haemodialysis care.
Document Type
Journal Article
Date of Publication
3-1-2026
Volume
52
Issue
1
PubMed ID
41574395
Publication Title
Journal of Renal Care
Publisher
Wiley
School
School of Medical and Health Sciences
Funders
Australian Government Research Training Program Scholarship (0.82133/C42F‐K220) / Edith Cowan University (26305)
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
Zhong, L., Steinwandel, U., Davies, H., Bayes, S., Jamboti, J., Kulkarni, H., & Chan, D. (2026). Preserving residual kidney function in haemodialysis: Current practices, challenges, and perspectives from renal clinicians. Journal of Renal Care, 52(1), e70045. https://doi.org/10.1111/jorc.70045