Abstract: TH-PO197
Changes in Ultrafiltration Rate (UFR) with Relative Blood Volume Monitoring (RBV-M)
Session Information
- Hemodialysis and Frequent Dialysis - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Balter, Paul, Renal Research Institute, New York, New York, United States
- Li, Yisha, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Taylor, Patrice B., Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Mullon, Claudy, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
Background
High UFRs during hemodialysis (HD) have been linked to increased risk of mortality, and avoidance of UFR ≥13 ml/hr/kg has been advised. However, limiting UFR may lead to volume overload. We examined the changes in UFR and related parameters among patients who were part of a one-year fluid management QI project with RBV-M at 20 Renal Research Institute clinics.
Methods
Patients included in the analysis were receiving HD at Baseline (BL; month before QI project) and at Month 12 of the QI project (M12). Crit-Line monitor (CLM-III, CLM-IV, or CLiC) was used to monitor relative blood volume during the QI project. All available data on ultrafiltration volume (UFV), HD treatment duration (TD), UFR, interdialytic wt gain (IDWG), and post-HD body weight (wt) were averaged monthly for each patient. Paired t-tests and McNemar’s tests were used to test for differences between BL and QI month 12 (M12).
Results
Treatment parameters at BL and M12 stratified by BL UFR are shown in Table. Pts with UFR<10 ml/kg/h experienced an increase in UFR by M12 (0.43 ml/kg/h) along with decreases in Post-HD wt of -1.1 kg and -1.0 kg in pre-HD wt. Pts with UFR>13 ml/kg/h experienced an average decrease in UFR of -2.34 ml/kg/h accompanied by a decrease in IDWG with no change in post-HD wt or TD. A similar, but less pronounced, pattern was observed for pts with UFR 10-13 ml/kg/h.
Conclusion
During a one-year fluid management QI project utilizing RBV-M, pts with UFR<10 ml/kg/h at baseline experienced an increase in UFR with a decrease in post-HD wt. Patients with UFR>10 ml/kg/h at baseline experienced a decrease in UFR accompanied by improvements in IDWG with stable post-HD wts. Treatment duration remained unchanged for all groups.
Funding
- Commercial Support –