Rituximab therapeutic levels may be maintained in dialysis patients. Hemodialysis does not remove rituximab. Peritoneal dialysis and hemodiafiltration remove some proteins from the blood, but not enough to affect drug levels. Dialysis treatment removes waste products and excess water from the body through the kidneys or other organs such as the heart. Waste products include urea nitrogen (BUN) and creatinine. The amount of time that you can live without your kidney function decreasing too much is called the "survival time" for people with chronic kidney disease (CKD). Most patients who need renal replacement therapy (dialysis or transplantation) die before they reach end-stage renal disease (ESRD). However, about one third of patients survive longer than 10 years after starting dialysis treatment. About half of all people with CKD will require some form of renal replacement therapy by the time they reach ESRD. Factors leading to the need for dialysis or transplantation include high levels of BUN and creatinine, which result from poor nutrition and excessive removal of nutrients and minerals during dialysis treatments; increasing acidity due to poor clearance of urine; decreased ability to fight infection; and loss of muscle mass caused by lack of proper nutrition.