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Abstract: SA-PO1047

Impact of Altitude on Dialysis Patient Characteristics and Outcomes

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Ash, Brian Scott, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Lindsay, Janice D., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Barometric pressure, oxygen pressure as well as ultraviolet radiation are environmental factors that variate by altitude and have the potential to impact outcomes. Patients undergoing hemodialysis (HD) tend to suffer from several chronic conditions and could vary depending on the elevation they reside in. We aimed to define the characteristics and outcomes of the HD population at a large dialysis provider (LDO) by the altitude of residence.

Methods

We used data from HD patients treated at the LDO in 2018. Patients were stratified by the average elevation of the state of residence extracted from the US Geological Survey. Average state elevations were defined as: high (>4000 feet), mid (1000 to 4000 feet), and low (<1000 feet). We defined patient demographics, comorbidities, clinical characteristics and outcomes in the different elevations.

Results

Among a population of 244720 HD patients, 59% resided at low elevation, 35% at mid elevation, and 6% lived at high elevation. The percentage of females varied from 41-43% in the three elevations, and age ranged from 63-64 years old. Low elevations had the lowest percentage of white and Hispanic patients (whites: 44% vs 55% and 68% at low, mid and high elevations respectively; Hispanics: 5%). Low elevations had the smallest percentage of patients with diabetes (66%, 69% and 70% at low, mid and high elevations), while it had the highest number of patients with heart diseases (congestive heart failure: 21% vs 19% and 13% at low, mid and high elevations; ischemic heart disease: 21% vs 19% and 12% for low, mid and high elevations; hypertension 66% vs 67% and 70%, at low, mid and high elevation). Patients more commonly received an extra HD treatment in higher elevations (7% vs 8% and 9% at low, mid and high elevation). Low elevation also had the highest hospitalization rates (1.9 vs 1.8 and 1.7 at low, mid and high elevation).

Conclusion

HD patient characteristics and outcomes vary by elevation. In low elevations heart diseases were more prevalent, patients more often received an extra HD treatment, and patients had higher hospital admission rates. Diabetes was more prevalent in higher elevations in HD patients. Further adjusted analysis are needed to identify the influences of altitude on practice patterns and outcomes.

Funding

  • Commercial Support