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Abstract: TH-PO313

Preliminary Analysis of the Effect of Blood Flow Rate Reduction on Post-Dialysis Fatigue

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Duggal, Vishal, Stanford University, Palo Alto, California, United States
  • Abra, Graham E., Stanford University, Palo Alto, California, United States
  • Reiterman, Marc, Satellite Healthcare, San Jose, California, United States
  • Hussein, Wael F., Satellite Healthcare, San Jose, California, United States
  • Schiller, Brigitte, Satellite Healthcare, San Jose, California, United States
Background

Post-dialysis fatigue is a common complaint among patients undergoing maintenance hemodialysis (HD). It is not known whether hemodialysis blood flow rate (Qb) affects post-dialysis fatigue. We aimed to determine if a reduction in Qb affected the time to recover from HD treatments in patients with significant baseline post-dialysis fatigue.

Methods

We conducted a randomized, controlled trial of patients undergoing maintenance HD ≥3x/week who reported post-dialysis fatigue ≥6 hours at baseline. Preliminary data included 94 subjects randomized to Qb reduction of up to 100 mL/min (minimum Qb 300 mL/min; intervention group, 47 subjects) or to usual care (control group, 47 subjects). Patients with borderline dialysis adequacy were excluded. Subjects were surveyed weekly for 4 weeks regarding their dialysis recovery time (DRT) using the validated question “How long did it take you to recover from dialysis?” Primary outcome was change in DRT.

Results

Mean age was 65.1±12.7 years, 62.8% were men, median vintage was 3.73 years (IQR 2.0–6.7), and 68.1% of subjects had diabetes. Baseline characteristics in post-randomization groups were fairly balanced. Prescribed Qb was reduced from 398±39.8 mL/min to 314±23.1 mL/min in the intervention arm. Prescribed Qb was 389±41.6 mL/min in controls. During the intervention period, median DRTs decreased in both groups (Figure 1). Repeated measures analysis performed on the difference from each time point to baseline did not show a significant difference between intervention and control arms [F(1,67) = 0.74, p = 0.39].

Conclusion

In maintenance hemodialysis patients with a baseline post-dialysis recovery time of 6 or more hours, we did not observe an effect of Qb reduction of up to 100 mL/min on post-dialysis recovery time.

Funding

  • Commercial Support