Abstract: SA-PO743

Achieving Dry Weight, Intradialytic Hypotension, and Outcomes in Patients Undergoing Hemodialysis

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Bou Slaiman, Salim, staten island university hospital, Staten Island, New York, United States
  • Zeineddine, Nabil, staten island university hospital, Staten Island, New York, United States
Background

Patients with end stage renal disease (ESRD) are known to have high rate of hospitalizations and increased mortality compared to the general population. These morbidities might be related to a set of complications that occur during hemodialysis (HD) sessions, such as hypotensive episodes. On the other hand, reaching the dry weight (DW) during a HD session was also linked to improved outcomes.

Methods

This is a retrospective study with patients recruited in a dialysis center in Staten Island, NY; 36 HD sessions per patient in 3 months duration, with the rate of hypotensive episodes (as defined by KDOQI) , and whether a DW was achieved or not, will be collected. Hospitalization rate and complications (cardiovascular and fistula-related) will be recorded for the following 12 months.

Results

49 patients with a mean age of 60.42 (±14.6) years and their 1729 HD session were analyzed so far. They were 50% males and 50% females. Results didn’t show any significant difference in hospitalization or complications in patients who had more episodes of hypotension (p=0.25), however a statistically significant difference was found between patients who achieved DW and those who didn’t in terms of having a clotted arteriovenous (AV) access (p=0.048). There was a statistically significant negative correlation between hypotension and achieving DW (R= -0.136; p= 0.022). Also female gender was strongly associated with more hypotensive episodes on one hand, and failure to achieve DW during HD sessions on the other hand (p=0.0001 for both differences).

Conclusion

The results seen so far didn’t appreciate any significant effect of hypotension or achieving DW during HD sessions on morbidity and complications in the following year except for a slightly significant difference in having a clotted AV access seen more in patients who achieved their DW; this might be secondary to a more aggressive ultrafiltration for attaining the target weight. The strong negative correlation between achieving DW and hypotensive episodes indicates that the main reason for not achieving DW is hypotension. On the other hand, females were more prone for intradialytic complications such as hypotension and failure to achieve DW. A larger population is needed for a better analysis and to further investigate any relation between intradialytic complications and morbidity and mortality in patients with ESRD.