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Kidney Week

Abstract: TH-PO201

Prevalence of Body Weight Variations in the Pre-Dialysis Period and the Effect of Hemodialysis Initiation: A Single-Centre Retrospective Observational Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Mohammed, Azharuddin, Armed Forces Hospital-Taif Region, Taif, Makkah, Saudi Arabia
  • Alazwari, Monther Nasser, Armed Forces Hospital-Taif Region, Taif, Makkah, Saudi Arabia
Background

Body weight(BW) changes rapidly during pre-dialysis(pre-D) period and is regularly monitored during pre-D clinics but less utilised as an indication for RRT initiation in isolation. Hemodialysis(HD) provides a target weight (TW).
Aims:To 1) Assess prevalence and magnitude of BW changes during pre-D 2) Measure the effect of RRT initiation on BW 3 months(m) post HD

Methods

We retrospectively examined BW changes of a large cohort of incident HD patients who attended Pre-D clinics between 2012-2016 (n=103). Excluded:Those with missing BW between 2-5 m in pre-D and 2-5 m after RRT initiation, previous PD, HD or fluid overload as indication for RRT initiation (n= 38).
W0, W1and W2 are the corresponding BW at -3 m(Pre-D clinic), pre-weight at 1stHD initiation and post-HD TW after +3 m. Delta BW is calculated as absolute and % change for Pre-D(W0-W1) and HD period(W1-W2). Weight loss and Weight gain data analysed using Past.V3 software.

Results

n= 65, mean age 68±12 yr, M:F 44:21. HD was RRT in all. Pre-D and HD intervals were similar 99 ± 29 Vs. 92 ± 13.6 days. Post-weight and TW were within 0.5±0.4 Kg.Weight loss seen in both pre-D and HD; it slowed modestly after HD initiation (66.4% to 56.9%) mainly in 0-5% (40% Vs. 26%) (Fig 1). Weight gain was mostly 0 - 9.9% on HD as compared to pre-D (38.4 Vs 27.7). High weight gainers of >10% BW reduced from 7.7% in the pre-D period to 4.6% on HD, probably reflecting closer monitoring of TW.
However, group comparison of pre-D and HD for % BW changes did not reach statistical significance for weight loss (difference between means 1.47, 95% CI -1.45 to 4.48, p=0.35) or weight gain (difference between means 0.12, 95% CI -2.86 to 3.11, p=0.93).

Conclusion

Uremic state is predominantly catabolic in both pre-D and HD period; RRT initiation can provide anabolic milieu. Increased recognition/incorporation of BW changes is needed as an added indication for RRT initiation. Body composition monitor use could well extend into pre-D clinics to guide bedside decisions.