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Kidney Week

Abstract: TH-PO238

Week-to-Week Variability of Dialysis Recovery Time

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Hussein, Wael F., Satellite Healthcare, San Jose, California, United States
  • Duggal, Vishal, Stanford University School of Medicine, Palo Alto, California, United States
  • Sun, Sumi J., Satellite Healthcare, San Jose, California, United States
  • Schiller, Brigitte, Satellite Healthcare, San Jose, California, United States
Background

Fatigue is identified by patients as a priority for research. Post-dialysis fatigue is common and associated with poor outcomes. Unpredictability of symptoms worsens the impact of these symptoms on patients. In a previous study, we prospectively recorded weekly dialysis recovery time (DRT) for four weeks in patients with prolonged DRT at baseline [Duggal et al. HDI. 2019]. Here, we report on the weekly variability of DRT in these patients.

Methods

Patients with DRT data from all four weeks were included in this study. We hypothesized that a change in DRT of four hours or more from the previous week was a significant fluctuation to impact symptom predictability and patient’s ability to plan activities after dialysis. We report on the proportion of patients who had at least two such fluctuations during the follow-up period. In addition, we report on within-patient week-to-week variability using within-patient ranges, standard deviations (SD), coefficients of variation and mean absolute differences (MAD).

Results

Seventy-four patients were included in this analysis; median age 64 years (IQR: 59 - 75), 32% female. During the follow-up period, 26% of patients had at least two recorded DRTs that were four hours or more different from the prior week. Median within-patient week-to-week DRT range, SD and MAD were 525 (180-960), 230 (77 – 464) and 209 (80 – 440) minutes respectively, and the coefficient of variation was 0.48 (0.22 – 0.87).

Conclusion

Among patients with long recovery time at baseline, we report substantial variability in week-to-week DRT. These fluctuations in symptoms increase the burden on hemodialysis patients. More attention is needed to study the variability of symptoms and its burden in terms of extent and effect.