Kidney Week

Abstract: FR-PO0072

Intradialytic Central Venous Oxygen Saturation Dynamics in Patients Transitioning from AKI to ESKD

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Nandorine Ban, Andrea, Renal Research Institute, New York, New York, United States

Andrea Nandorine Ban, MS, MSc

• Van Zandt, Carly R., Renal Research Institute, New York, New York, United States

Carly R. Van Zandt, MS

• Desai, Priya, Renal Research Institute, New York, New York, United States

Priya Desai, MPH

• Chaudhuri, Sheetal, Renal Research Institute, New York, New York, United States

Sheetal Chaudhuri, PhD

• Neri, Luca, Renal Research Institute, New York, New York, United States

Luca Neri, MD, PhD

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko, MD, FASN

• Usvyat, Len A., Renal Research Institute, New York, New York, United States

Len A. Usvyat, PhD

• Zhang, Hanjie, Renal Research Institute, New York, New York, United States

Hanjie Zhang, PhD

Background

Acute kidney injury (AKI) requiring dialysis can progress to end-stage kidney disease (ESKD). Understanding physiological markers during AKI may provide insight into longer term outcomes of those patients. We compared intradialytic central venous oxygen saturation (ScvO₂) in in-center hemodialysis (HD) patients during AKI and after transition to ESKD.

Methods

We analyzed ScvO₂ data from a large U.S. HD cohort monitored between Jan 2021 to July 2023 with the Crit-Line device (Fresenius Medical Care). Only patients who initiated dialysis for AKI and later transitioned to ESKD were included. Patients had to have central venous catheter as vascular access. ScvO₂ was measured every 10 seconds and compared between treatments during AKI and during the first 120 days of ESKD.

Results

2,383 patients were analyzed. Intradialytic ScvO₂ at HD session start (first 5–20 min) was 62.9±7.1% (AKI) vs. 65.2±8.1% (ESKD), mean±standard deviation (SD). ScvO₂ at HD session end (last 5-20 min) was 62.3±7.7% (AKI) vs. 63.2±8.8% (ESKD) (Table 1). The intradialytic ScvO₂ drop was 0.65±4.1% (AKI) vs. 2.0±4.3% (ESKD) (Figure 1).

Conclusion

A greater intradialytic ScvO₂ drop was observed in ESKD treatments compared to AKI, potentially due to higher ultrafiltration volume. We hypothesize that a larger ScvO₂ drop during dialysis may put patients at a higher risk of progression from AKI to ESKD. Evaluation of ScvO₂ as a predictive marker for renal recovery is warranted.

Table 1: Patient-level ScvO₂ (mean±SD) by treatment period. Not all patients had data in both periods.

Figure 1: Distribution of ScvO₂ change during treatment.

Funding

• Commercial Support – Renal Research Institute LLC, a wholly owned subsidiary of Fresenius Medical Care Holdings Inc.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025nq3yn6nq