Kidney Week

Abstract: TH-PO338

Association of Treatment Time and One Year Change in Residual Renal Urea Clearance in Hemodialysis Patients

Session Information

• Dialysis: Dialysate and Clearance
  October 25, 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

• Nguyen, Steven, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Steven Nguyen,

• Lee, Yuji, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Yuji Lee,

• Park, Christina, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Christina Park,

• Hsiung, Jui-Ting, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Jui-Ting Hsiung,

• Rhee, Connie, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Connie Rhee,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Kamyar Kalantar-Zadeh,

• Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Elani Streja,

Background

Longer hemodialysis (HD) treatment time has been associated with lower mortality risk. However, there are scant data regarding the effects of increased treatment time with regards to residual renal function (KrU).

Methods

We retrospectively examined associations of baseline (first 91 days of dialysis) HD treatment time and 1-year renal residual urea clearance change in 6,659 patients receiving thrice weekly HD at a large dialysis organization between 2007-2011 and who survived the first year of dialysis and had available KrU data in the first and fifth patient-quarters. Patients were grouped into 4 exposure categories based on average treatment duration during the baseline quarter. Significant KrU loss was defined as a drop ≥20% ([KrU quarter 5 - baseline KrU quarter] / baseline KrU). Logistic regression models were used with covariate adjustment for case-mix, markers of malnutrition and inflammation, and ultrafiltration volume.

Results

The mean age of patients in the cohort was 62±14 years and 35% were female. Treatment duration of <3 hours was associated with higher risk for KrU loss. Longer treatment durations were linearly associated with lower risk of significant KrU loss. These trends persisted across all models of adjustment. In the shortest duration category (<3 hours), the fully adjusted odds ratio (OR) was 1.40 (95% CI, 1.16, 1.69). In the longest duration category (>4 hours), the OR was 0.81 (95% CI, 0.68, 0.98 ). [Figure]

Conclusion

Among HD patients, shorter treatment duration was found to be associated with higher odds of loss of KrU whereas longer treatment duration was found to be associated with lower odds of KrU loss. Further studies are needed to understand the relationship between treatment time and KrU loss.

Funding

• NIDDK Support