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Abstract: PO0898

The Association of Interdialytic Weight Gain in Long Intervals with Residual Renal Function Decline

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Miyasato, Yoshikazu, University of California Irvine, Irvine, California, United States
  • Miyagi, Tsuyoshi, University of California Irvine, Irvine, California, United States
  • Narasaki, Yoko, University of California Irvine, Irvine, California, United States
  • Kimura, Hiroshi, University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
  • Streja, Elani, University of California Irvine, Irvine, California, United States
Background

Preservation of residual renal function (RRF) in dialysis patients is important for better prognosis. The effect of interdialytic weight gain (IDWG) on change of RRF has not been investigated well. We examined the association of IDWG in long intervals (i.e. 2-day breaks between dialysis treatments) with rapid decline of RRF.

Methods

This retrospective cohort study included 6425 patients who initiated hemodialysis in a large dialysis organization in the United States from 2007 to 2011. We examined the association between seven categories of IDWG in long intervals (IDWGL) and rapid decline of RRF using logistic regression model. Rapid decline of RRF was defined as the percent decline in renal urea clearance (KRU) greater than the median value of the cohort in the first year after dialysis initiation. Seven categories of IDWGL were as follows: 0-<1%, 1-<2%, 2-<3%, 3-<4%, 4-<5%, 5-<6%, and ≥6%. We also examined continuous associations between IDWGL and rapid decline of RRF using restricted cubic spline analysis.

Results

Higher categories of IDWGL were associated with increased risk of rapid decline of RRF. The odds ratios (95% confidence intervals) of rapid decline of RRF for 3-<4%, 4-<5%, 5-<6%, and ≥6% were 1.04 (0.90-1.20), 1.31 (1.09-1.56), 1.19 (0.94-1.51), and 1.50 (1.14-1.97) (Reference: 2-<3%) (Figure a). The restricted cubic spline analysis showed that risk of rapid decline of RRF increased when IDWGL exceeded 2% (Figure b).

Conclusion

Our results showed higher IDWGL was associated with higher risk of rapid decline of RRF. IDWGL exceeded 2%, especially ≥4%, seems to be thresholds for higher risk of RRF decline.