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Abstract: TH-PO333

Effect of Dialysate Potassium (K) Bath During Daily Hemodialysis (DHD) on Serum K Concentration After Transfer from In-Center Hemodialysis (ICHD)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Leypoldt, J. Ken, Unaffiliated , San Clemente, California, United States
  • Kraus, Michael A., NxStage Medical, Inc, FISHERS, Indiana, United States
  • Jaber, Bertrand L., St. Elizabeth's Medical Center, Boston, Massachusetts, United States
  • Weinhandl, Eric D., NxStage Medical, Inc., Victoria, Minnesota, United States
  • Collins, Allan J., NxStage Medical, Inc., Victoria, Minnesota, United States
Background

The choice of the dialysate K bath influences serum K concentration during thrice-weekly ICHD; however, the prescription of the dialysate K bath during DHD has not been extensively studied. We examined the effect of the dialysate K bath during DHD on serum K concentration after transfer from ICHD.

Methods

This post hoc analysis evaluated patients who transferred from ICHD to DHD during the FREEDOM Study (N=345). DHD was performed at low dialysate flow rates; treatment frequency per week and dialysate volume per session were 5.9±0.2 and 22.2±4.0 L, respectively. The change in serum K concentration after transfer from ICHD to DHD (ΔK) was calculated based on the average serum K concentration from the last 3 months of ICHD and the first 3 months of DHD.

Results

ICHD serum K concentration was 5.3±0.7, 4.8±0.6 and 4.4±0.5 mEq/L with ICHD dialysate K bath of 1, 2 and 3 mEq/L, respectively. Mean±SD (N) serum ΔK for combinations of ICHD and DHD dialysate K baths are tabulated. By multiple linear regression, ΔK was inversely associated with both higher ICHD dialysate K bath (P<0.001) and ICHD serum K concentration (P<0.001) when DHD dialysate K bath was 1 mEq/L; no such associations were noted when DHD dialysate K bath was 2 mEq/L.

Conclusion

Transfer from ICHD to DHD at low dialysate flow rates with a dialysate K bath of 1 mEq/L resulted in decreased serum K concentrations, but no changes in serum K concentration occurred with a dialysate K bath of 2 mEq/L. Control of serum K concentration during DHD at low dialysate flow rates is effective; however, the choice of the dialysate K bath can be informed when transfer is from ICHD to DHD.

 Serum ΔK (mEq/L)
ICHD Dialysate K Bath (mEq/L)DHD Dialysate K Bath of 1 mEq/LDHD Dialysate K Bath of 2 mEq/L
1-0.42±0.78 (46)*0.40 (1)
2-0.47±0.61 (229)*-0.05±0.43 (11)
3-0.36±0.74 (49)**-0.09±0.44 (9)
All-0.45±0.66 (324)*-0.04±0.42 (21)

*(P<0.001) & **(P=0.0013) denote different from zero.

Funding

  • Commercial Support