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Kidney Week

Abstract: TH-PO295

Loss of Residual Kidney Function at One Year in Diabetic and Non-Diabetic Incident Patients Treated with Incremental Hemodialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Saudan, Patrick, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Jaques, David Antoine, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Ponte, Belen, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Dufey Teso, Anne, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Haidar, Fadi, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Carballo, Sebastian, Service of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
  • De Seigneux, Sophie M., Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
Background

Residual kidney function (RKF) is better preserved with incremental haemodialysis (I-HD) as compared to conventional thrice-weekly HD (TW-HD). Presence of diabetes is associated with a faster decline of RKF in TW-HD. We aimed to analyze the RKF decline at one-year in diabetic versus non-diabetic patients initiating dialysis with I-HD.

Methods

We conducted an analysis of a prospectively assembled cohort in a single university centre including all adults initiating I-HD from January 2013 to December 2021. Outcomes were maintenance of incremental dialysis at one year and RKF decline at one year (or transition to TW-HD) according to the presence of diabetes.

Results

Of 264 patients who started hemodialysis, 93 initiated dialysis with I-HD of whom 30 were diabetics. At dialysis initiation, age, eGFR, comorbidity score, daily diuresis and urea clearance (KrU) were similar between non-diabetic and diabetic patients. Transition to TW-HD occurred after a mean duration of 16 +/- 15 months and 11+/- 10 months in non-diabetic and diabetic patients respectively (p= 0.07). At one year, the percentages of non-diabetic patients and diabetic patients still on I-HD were 51% and 37% respectively. At one-year, non-diabetic and diabetic patients had a daily diuresis decline of 32 and 37 % (p= 0.07) and a KrU decline of 34 and 46 % (p< 0.01) respectively.

Conclusion

RKF decline is more rapid in incident diabetic patients versus non-diabetic patients treated with I-HD and its duration before transition to TW-HD is shorter in patients with diabetes. Nephrologists should be aware that transition to TW-HD could be faster in diabetic patients.