Abstract: SA-PO683

Quasi-Frequent Hemodialysis Affects Hospitalization for Cardiovascular Disease and Cardiac Function in ESRD Patients with Severe Heart Failure

Session Information

Category: Dialysis

  • 604 Home and Frequent Dialysis

Authors

  • Banshodani, Masataka, Tsuchiya General Hospital, Hiroshima, Japan
  • Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan
  • Moriishi, Misaki, Tsuchiya General Hospital, Hiroshima, Japan
  • Shintaku, Sadanori, Tsuchiya General Hospital, Hiroshima, Japan
  • Tsuchiya, Shinichiro, Tsuchiya General Hospital, Hiroshima, Japan
Background

Previous reports indicated that frequent hemodialysis (FHD) maintained cardiac function. However, no reports have evaluated the impact of quasi-FHD (q-FHD) on hospitalization for cardiovascular diseases (CVDs) and cardiac function in end-stage renal disease (ESRD) patients with severe heart failure.

Methods

This is a retrospective observational study that evaluated hospitalizations for the period from 1 year before to 1 year after q-FHD initiation (≥4 times a week) and ejection fraction (EF) by using echocardiography in ESRD patients with severe heart failure (New York Heart Association Functional Classification III or IV) at a single center between 1995 and 2014.

Results

Of 1,955 hemodialysis (HD) patients, 60 (3.1%; 42 men; mean age, 65.4 years; mean dialysis vintage, 80.0 months) started q-FHD (mean, 4.3 ± 0.7 times a week) and 52 continuously received q-FHD (4.6 ± 0.8 times a week) 1 year later. The 1-year mortality rate after q-FHD initiation was 13.3%. The mean EF decreased from 61.8% at dialysis initiation to 50.6% at q-FHD initiation (P < 0.001) but did not change 1 year later (49.4%; P = 0.7). All-cause hospitalization rates (per person-year) were similar between before and after q-FHD initiation (1.79 [102 hospitalizations] vs 2.07 [115 hospitalizations]; P = 0.2). On the other hand, the emergency hospitalization rate for CVDs significantly decreased from 0.73 to 0.37 after q-FHD initiation (P = 0.002). However, the emergency hospitalization rates for infectious diseases, including vascular access-related infection, were similar between before and after q-FHD initiation (0.12 vs 0.16; P = 0.5).

Conclusion

The hospitalization rate for CVDs significantly decreased after the q-FHD initiation in the ESRD patients with severe heart failure. Moreover, q-FHD maintained cardiac function in these patients. Further multicenter studies are needed to evaluate these findings.