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Abstract: PO0868

Interdialytic Weight Gain in Long Intervals and Mortality Among Maintenance Hemodialysis Patients

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
  • Streja, Elani, University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
Background

Interdialytic weight gain (IDWG) is an important factor for sudden death on the first dialysis day right after long interdialytic intervals (i.e. 2-day breaks between dialysis treatments) in hemodialysis patients. We defined IDWG in long intervals (IDWGL) as the IDWG during 2-day breaks. In this study we examined the association between IDWGL and medium-term mortality.

Methods

This retrospective cohort study included 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 IDWGL and all-cause mortality using Cox regression model. 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 mortality using restricted cubic spline analysis.

Results

We examined mortality in 35225 patients. The mean age (and standard deviation) was 62±15 years, and 8112 died during the median follow-up period of 1.4 years. Higher categories of IDWGL were associated with increased risk of mortality. The hazard ratios (95% confidence intervals) of all-cause mortality for 3-<4%, 4-<5%, 5-<6%, and ≥6% were 1.09 (1.03-1.16), 1.14 (1.06-1.23), 1.17 (1.06-1.29), and 1.25 (1.14-1.38) (Reference: 2-<3%) (Figure a). The restricted cubic spline analysis showed that risk of mortality increased when IDWGL exceeded 2% (Figure b).

Conclusion

IDWGL exceeded 2% was associated with higher risk of mortality. Our results suggest IDWGL can be a risk parameter for medium-term mortality.