ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO302

Effects of the Long Interdialytic Period on Physical Performance in Patients on Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Arroyo, Eliott, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Coggan, Andrew R., Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
  • Karp, Sharon L., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Moe, Sharon M., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States
Background

Reduced physical function in patients on hemodialysis (HD) is strongly associated with increased risk of falls, fractures, disability, morbidity, and mortality. The long (3-day) interdialytic period is linked to fluid overload, metabolic acidosis, electrolyte imbalances, and cardiac and skeletal muscle failure—physiologic alterations that can impair physical function. Despite this, the effects of interdialytic periods on metrics of physical performance are largely unknown. Herein, we sought to determine whether physical performance is impaired following the long interdialytic period.

Methods

We analyzed data from the ongoing, “Effects of long interdialytic intervals on Cardiovascular Functional Capacity (ECON)” study, a randomized crossover trial of patients on conventional HD. Comprehensive assessment of mobility and performance capacity were performed on three study visits: post-HD (baseline; BL), and at the end of the 2-day and 3-day interdialytic intervals. Fluid status was assessed via bioelectrical impedance spectroscopy.

Results

A total of 17 patients (n=12 men, age=52±11 years, dialysis vintage=76±68 months) were included in this analysis. Body weight (BL=79.8±20.2 kg; 2-day=81.1±20.6 kg; 3-day=82.1±21.0 kg; p<0.001), total body fluid (TBF; p<0.001), extracellular fluid (ECF; p<0.001), and fluid overload (p<0.001) were significantly higher at 3-day intervals compared to both 2-day and BL. Both usual gait speed (BL=1.1±0.2 m/s; 2-day=1.0±0.1 m/s; 3-day=0.9±0.2 m/s; p=0.02) and fast gait speed (BL=1.5±0.4 m/s; 2-day=1.4±0.3 m/s; 3-day=1.3±0.3 m/s; p=0.033) were significantly slower in 3-day compared to BL, while no significant differences were observed between 2-day and BL. Usual gait speed was significantly correlated with TBF% (r=0.39, p=0.005) and ECF% (r=–0.42, p=0.002). Fast gait speed was significantly correlated with TBF% (r=0.52, p<0.001), ECF% (r=–0.49, p<0.001) as well as body weight (r=–0.39, p=0.004).

Conclusion

Our preliminary findings indicate that the 3-day interdialytic interval is associated with impaired physical performance. We postulate that excess volume accumulation during the 3-day interdialytic period may be a major contributor to impaired physical function.

Funding

  • Private Foundation Support