ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: SA-PO792

Individual-Level Changes in Interdialytic Weight Gain and Blood Pressure before Dialysis Treatment Are Associated with Same-Day Extreme Heat Events within Northeastern US Cities

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD


  • Topping, Alice, Renal Research Institute, New York, New York, United States
  • Remigio, Richard V, University of Maryland, College Park, Washington, District of Columbia, United States
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Maddux, Franklin W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Kinney, Patrick, Boston University School of Public Health, Boston, Massachusetts, United States

In previous work, we have observed the effect of seasonal changes on interdialytic weight gain (IDWG) and pre-treatment blood pressure among hemodialysis (HD) patients. We sought to understand this seasonal effect at a finer temporal resolution by joining averaged daily ambient weather data with individual-level patient data. We focused on patients residing within northeastern United States cities.


Clinical data were extracted from Fresenius Medical Care-North America (FMC-NA) database for HD patients in Boston (N=1439), New York (N=2241), and Philadelphia (N=3762) between 2001 and 2012. Using weather data from the National Oceanic and Atmospheric Agency (NOAA), we defined a heat wave event as average ambient air temprature in the 99th percentile for each city. We applied linear mixed-effects regression modeling to estimate the effect of same-day heat wave event exposures on IDWG and, systolic blood pressure (pre-SBP), and diastolic blood pressure (pre-DBP) for patients in each city.


All three cities demonstrated associations between same-day heat wave events and IDWG percentage. When compared to non-heat wave events, individual-level IDWG percentage can decrease up to 0.34 % on average (Figure 1a). Same-day heat wave effects on blood pressure demonstrated associations for all three cities. When compared to non-heat events, pre-SBP and pre-DBP can decrease up to 3.28 mmHg and 1.45 mmHg on average, respectively (Figure 1b,c).


Same-day heat wave exposures demonstrated a consistent effect on IDWG percentage and blood pressure among individual patients in the northeastern region of the USA. Our preliminary findings demonstrate a potential relationship between outdoor heat events and important clinical measures in hemodialysis patients. Further work is needed to account for possible regional-specific variation related to these clinical measures.


  • Commercial Support