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Kidney Week

Abstract: PO1151

Assessment of Estimated Dry Weight in Dialysis Patients Undertaking Kidney Transplantation by Evaluating Post-Transplant Weight: The Kidney Knows Best

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Hodgins, Spencer, Baystate Medical Center, Springfield, Massachusetts, United States
  • Chapagain, Bikash, Baystate Medical Center, Springfield, Massachusetts, United States
  • Tarasaria, Twara Karan, Baystate Medical Center, Springfield, Massachusetts, United States
  • Chait, Yossi, University of Massachusetts System, Boston, Massachusetts, United States
  • Germain, Michael J., Baystate Medical Center, Springfield, Massachusetts, United States
  • Greco, Barbara A., Baystate Medical Center, Springfield, Massachusetts, United States
Background

The consequences of volume overload include recurrent hospitalizations and increased mortality in dialysis patients. Dry weight (EDW) is estimated in dialysis patients to provide a target for ultrafiltration and to prevent the consequences of volume overload. New kidney transplant recipients with good allograft function provide a unique opportunity to evaluate the accuracy of EDW. With the assumption that a good functioning kidney allograft would return the patient to their optimal dry weight (ODW), we compared the differences between EDW and ODW in a cohort at our center.

Methods

We retrospectively reviewed 138 adult kidney transplant recipients at Baystate Medical Center between June 2015 and October 2019. Patients were excluded on the basis of not achieving a serum creatinine of ≤1.5 mg/dl at 2 weeks post-transplant. ODW was defined as the weight at 2 weeks in a patient with good allograft function. Patients with EDW in the range +3% and -1% of ODW were considered to be euvolemic pre-transplant. Patients with EDW below and above that range were considered hypovolemic and hypervolemic, respectively. 35 patients met criteria and were included in the analysis.

Results

The mean (SD) age was 54.3 (12.7) years with 52% male. 31.4% of patients had live donors. Based on pre-transplant EDW values, 23% were above (hypovolemia), 17% within, and 60% below (hypervolemia) the range of euvolemia (Figure 1).

Conclusion

We conclude that many dialysis patients (83%) may not be at their ODW. This illustrates the importance of finding novel tools to help achieve accurate dry weight patient undertaking dialysis in order to reduce hospitalizations and improve mortality.

Figure 1. Box Plot Showing the normalized weight differeince in %.