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

Authors

  • 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
Background

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.

Methods

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.

Results

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).

Conclusion

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.

Funding

  • Commercial Support