Kidney Week

Abstract: FR-PO813

All-Cause Mortality in Relation to Intradialytic Relative Blood Volume and Central-Venous Oxygen Saturation Among Hemodialysis Patients

Session Information

• Dialysis: Hospitalization and Mortality
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Zhang, Hanjie, Renal Research Institute, New York, New York, United States

Hanjie Zhang,

• Preciado, Priscila, Renal Research Institute, New York, New York, United States

Priscila Preciado,

• Chan, Lili, Icahn School of Medicine at Mount Sinai , New York, New York, United States

Lili Chan,

• Thijssen, Stephan, Renal Research Institute, New York, New York, United States

Stephan Thijssen,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

Background

Relative blood volume (RBV) and central venous oxygen saturation (ScvO₂) monitoring is increasingly adopted. We previously identified that at higher ScvO₂ levels, that RBV had only a small effect on mortality risk, whereas at lower ScvO₂ levels, RBV tends to drive mortality risk. In this study, we further explored the association between RBV and ScvO₂ values on all-cause mortality.

Methods

This is a retrospective multicenter cohort study of HD patients with central-venous catheter (CVC) as vascular access from 17 Renal Research Institute clinics from January 2012 to June 2017 where the Crit-Line® Monitor (CLM) is used. The CLM allows for monitoring of extracorporeal hematocrit (Hct) and ScvO₂. The patients were stratified into 2 groups depending on their RBV and ScvO₂ at 3 hours (mean values between minutes 170 and 190) into HD.

Results

We included 151 patients with a total of 3,937 HD treatments. The median follow-up time was 2.8 years. The patients were stratified into 2 groups, 52 patients with their RBV larger than 91.74% and ScvO₂ lower than 56.72% at 3 hours into HD were labeled right corner patients (based on the position from our last study [1]). The results indicate a significantly increased mortality in patients with lower ScvO₂ and higher RBV levels compared to others (Figure 1 KM plot). Multivariate Cox analysis with different levels of adjustments corroborated the higher hazards ratios for all-cause mortality in these patients.

Conclusion

We found that patients with lower ScvO₂ and higher RBV levels had higher mortality. These findings may be related to patients’ volume status and cardiac function.

References
Hanjie Zhang et. al. Association of intradialytic relative blood volume and central-venous oxygen saturation with mortality among hemodialysis patients. ERA EDTA 2018 abstract.

Funding

• Commercial Support – Fresenius medical care north america