Kidney Week

Abstract: SA-PO681

Change in Blood Pressure and Body Weight in Incremental Hemodialysis Patients

Session Information

• Home and Frequent Dialysis
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 604 Home and Frequent Dialysis

Authors

• Hur, Inkyong, UC Irvine, Orange, California, United States

Inkyong Hur,

• Obi, Yoshitsugu, UC Irvine, Orange, California, United States

Yoshitsugu Obi,

• Streja, Elani, UC Irvine, Orange, California, United States

Elani Streja,

• Soohoo, Melissa, UC Irvine, Orange, California, United States

Melissa Soohoo,

• Rhee, Connie, UC Irvine, Orange, California, United States

Connie Rhee,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Kalantar-Zadeh, Kamyar, UC Irvine, Orange, California, United States

Kamyar Kalantar-Zadeh,

Background

Fluid status is expected to improve by increasing hemodialysis (HD) frequency from twice-weekly to thrice-weekly (i.e., incremental HD), but there are scarce data about how much improvement in blood pressure that can be achieved in such patients.

Methods

We retrospectively examined 569 HD patients who transitioned from twice-weekly to thrice-weekly HD within 3 months (M). We compared the pre-dialysis systolic BP (SBP) and post-dialysis body weight (BW) before and after the transition (i.e., -3M to 3M). Data at -1M served as the reference and SBP was categorized into three groups (i.e., <140 [27%], 140-<160 [42%], and ≥160 mmHg [31%]).

Results

The mean±SD age of the cohort was 66±14 years and included 46% women. SBP was increased up to -1M. Patients with the highest baseline SBP showed the greatest improvement in SBP after transition (-7.6±13.1, -10.4±15.8, and -11.9±15.9 mmHg at 1M, 2M, 3M, respectively; p<0.001) while patients with the lowest showed slightly increased (0.9±10.2, 1.4±12.0, 3.3±12.9 mmHg at 1M, 2M, 3M, respectively; p=0.022). Decreasing trends in post-dialysis BW after transition was consistently observed across the three groups, but was greater in higher baseline SBP patients (-0.7±1.8, -1.0±2.7, and -1.2±3.0 Kg at 1M. 2M, 3M, respectively; p<0.001) [Figure ].

Conclusion

The transition from twice-weekly to thrice-weekly frequency resulted in an improvement in pre-dialysis blood pressure control especially in patients with higher baseline SBP, which coincided with decreasing trends in post-HD body weight.

Funding

• NIDDK Support