Abstract: PO1784
Crit-Line Monitoring Effect on Blood Pressure Control in ESRD Patients Undergoing In-Center Hemodialysis
Session Information
- Hypertension and CVD: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Meier, Maggie, Washington University in St Louis, St Louis, Missouri, United States
- Iftikhar, Hassaan, Washington University in St Louis, St Louis, Missouri, United States
- Li, Alexandria Y., Washington University in St Louis, St Louis, Missouri, United States
- O Brien, Frank J., Washington University in St Louis, St Louis, Missouri, United States
Background
Patients with end stage renal disease (ESRD) are admitted to the hospital about twice per year, with a 35% readmission rate. Cardiovascular disease (CVD) makes up 28% of admissions; 38% of patients with CVD admissions have pulmonary edema. Fluid overload in ESRD increases morbidity and mortality. Fluid management improvements have potential to positively impact clinic outcomes in dialysis patients.
Methods
This was a prospective cohort study with adult patients at two outpatient dialysis facilities on the Washington University in St Louis Campus. Our inclusion criteria were patients with consistent 3x weekly in center hemodialysis defined as 80% attendance in the 30 days prior to the study. A critline protocol was implemented by the treatment team (Figure 1).
Results
Among 58 qualified patients, average age was 59. 77% were African American with male predominance (57%). Average BMI was 29. In the Critline cohort, systolic blood pressure trended down (Figure 2). In the initial 25 weeks, average number of antihypertensive medications per patient decreased from 2.6 to 1.8. The number of admissions for fluid overload stayed stable at 10, however readmissions decreased from 4 to 1.
Conclusion
Implementing a Critline protocol trended towards improvements in blood pressure and reduced number of antihypertensives medications. Our findings suggest that a protocolized approach to fluid management using critline will improve our patients outcomes.