Abstract: FR-PO1110
Impact of Using a Dietitian Acuity-Based Risk Score for Patients with ESKD
Session Information
- Health Maintenance, Nutrition, and Metabolism
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Willetts, Joanna, Renal Research Institute, New York, New York, United States
- Roh, Hokyung A, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Shepherd, Mary Kay, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Bissett, Jamie, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Han, Hao, Renal Research Institute, New York, New York, United States
- Chew, Anna, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Carver, Michelle, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Chatoth, Dinesh K., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Usvyat, Len A., Renal Research Institute, New York, New York, United States
- Chaudhuri, Sheetal, Renal Research Institute, New York, New York, United States
Background
End-Stage Kidney Disease (ESKD) Patients face significant dietary challenges, including carefully managing fluid, sodium, and phosphorus intake, requiring ongoing support from registered dietitians (RD), who play a critical role in guiding nutritional care. To improve the prioritization of care and enhance clinic workflow, an Acuity-Based Risk Score (ABRS) was developed. This tool helps identify patients at higher nutritional risk who would benefit most from RD intervention. In this analysis, we assess the impact of implementing the RD ABRS on ESKD patient care.
Methods
We studied adult, in-center hemodialysis (IHD) patients who treated from 01JAN2024 to 31DEC2024. Clinics where RDs reported using the RD ABRS to guide patient evaluations were identified through surveys. Using propensity score matching at the facility level, based on region and demographic characteristics, we identified comparison clinics where the RD ABRS was not reported to be utilized. To assess the impact of RD ABRS use, we calculated the annual rate of fluid-related hospital admissions for both groups, adjusting for confounding factors such as time spent in each acuity level, number of RD assessments, patient age, gender, dialysis vintage, and clinic state.
Results
A total of 33 clinics, comprising 2675 adult IHD patients, reported using the RD ABRS. Using propensity score matching, we identified 66 comparable clinics with 5839 adult IHD patients, that did not report using RD ABRS. The annual rate of fluid-related hospital admissions was 0.34 in clinics using the ABRS, compared to 0.40 in the matched clinics without ABRS use (Table 1). This difference was statistically significant, indicating a potential association between ABRS use and reduced fluid-related hospitalizations.
Conclusion
We observed an association between the use of the RD ABRS and improved fluid-related hospitalizations among IHD patients. These findings suggest that the RD ABRS may support dietitians in prioritizing and delivering timely nutritional interventions for ESKD patients. Further studies are needed to confirm this association.
Fluid Related Hospital Admissions per patient year (ppy)
| Hospitalization Rate (ppy), 95% Confidence Interval | |||
| RD ABRS User Facility | 0.34, (0.31, 0.37) | ||
| RD ABRS Non-User Facility | 0.40, (0.37, 0.43) | ||
| Odds Ratio | 1.19, (1.10, 1.30) | <0.0001 | |
Funding
- Commercial Support – Fresenius Medical Care