Abstract: SA-PO684

Change in Ultrafiltration Volume in Incremental Hemodialysis

Session Information

Category: Dialysis

  • 604 Home and Frequent Dialysis

Authors

  • Hur, Inkyong, UC Irvine, Orange, California, United States
  • Obi, Yoshitsugu, UC Irvine, Orange, California, United States
  • Streja, Elani, UC Irvine, Orange, California, United States
  • Rhee, Connie, UC Irvine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, UC Irvine, Orange, California, United States
Background

Incremental hemodialysis (HD) is a strategy of the gradual increase from twice-weekly to thrice-weekly HD in incident ESRD patients. While it is expected that augmentation of dialysis frequency leads to improvement in patients’ health status, there are scarce data about changes in ultrafiltration in such patients.

Methods

We retrospectively examined 569 HD patients who underwent incremental HD between 2007 and 2011. We compared the ultrafiltration volume (UFV) per session and weekly interdialytic weight gain (IDWG) before and after the transition (i.e., -3 months (M) to 3M). Ultrafiltration (UF) at -1M served as the reference and was categorized into tertiles ( <1.7, 1.7 to <2.8, and ≥2.8 L/session).

Results

The mean±SD age of the cohort was 66±14 years, and included 46% women. Patients with the highest baseline UFV showed a decreasing trend in UFV/session after transition (-0.3±0.7,-0.5±0.7, and -0.5±0.7 L at 1M, 2M, 3M, respectively; p<0.001), but patients with the lowest baseline UFV paradoxically showed an increasing trend (0.1±0.6, 0.3±0.7, and 0.4±0.7 L at 1M, 2M, 3M, respectively; p<0.001). Increases in weekly IDWG after the transition were consistently observed across UFV tertiles, but were greater among patients with lower baseline UFV (2.8±1.8, 3.5±1.9, and 4.1±2.2 L at 1M, 2M, 3M, respectively; p<0.001) [Figure].

Conclusion

Transitioning from twice-weekly to thrice-weekly HD resulted in less UFV/session among patients with higher baseline UFV, but paradoxically resulted in increased UFV/session among patients with the lowest baseline UFV. Weekly IDWG increased irrespective of baseline UFV.

Figure

Funding

  • NIDDK Support