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Kidney Week

Abstract: PO0797

Association of Length of Interdialytic Interval and Patient-Reported Symptoms

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wen, Huei Hsun, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chauhan, Kinsuk, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Nadkarni, Girish N., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

Symptom burden of patients on in-center hemodialysis (HD) is high. Hospitalization and mortality is higher after the long interdialytic interval due to accumulation of fluid and electrolytes. It is unclear whether symptom burden is affected by the length of interdialytic interval.

Methods

We surveyed patients ≥18 years old, on HD for ≥30 days, and on HD three times a week at the Mount Sinai Kidney Center. Patients completed a survey about presence and severity (5 point scale) of 21 symptoms at the end of their HD treatments for 12 sessions. Symptom severity was calculated by multiplying the symptom with the severity and could range from 0 to 84, it was then summed per survey and the mean value per patient was calculated. We used negative binomial regression to determine the association of interval with symptom count.

Results

During the study period, 97 HD patients completed all surveys. The mean age was 56±14 years, 52% were female, and 52% were Black. The majority of patients reported symptoms, which ranged from a low of 8% for chest pain to 61% for fatigue (Figure 1A). More patients reported having ≥1 symptom after the long interdialytic interval than after the short interdialytic interval 67% vs 59%, P=0.01. Mean symptom severity was higher after the long interdialytic interval (5.8±0.5 vs. 4.7±0.5, P<0.001) (Figure 1B). Symptoms that tended to be more common after the interdialytic interval were fatigue, itching, dry mouth, bone pain, and restless legs (Figure 1C). After adjustment for age, gender, and race, the incidence rate of symptoms was 20% higher after the long interval (IRR 1.2, 95% CI 1.09-1.33).

Conclusion

Symptoms are common in patients on maintenance HD. Symptom burden is slightly higher after the long interdialytic interval than the short interdialytic interval.

Figure 1: A) Percentage of patients reporting symptom at any point, B) mean severity score by interdialytic period, and C) percentage of patients reporting symptoms by interdialytic interval.

Funding

  • NIDDK Support