Abstract: FR-PO0485
Delivered Treatment Time and Hospitalization Rates Among 141,397 Patients on In-Center Hemodialysis
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Lasky, Rachel A., Renal Research Institute, New York, New York, United States
- Ficociello, Linda, Renal Research Institute, New York, New York, United States
- Flythe, Jennifer E., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Hippen, Benjamin E., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
Background
Dialysis treatment time (TT) is a modifiable aspect of the hemodialysis (HD) prescription, and lengthening TT may be beneficial to patient health even when ultrafiltration rates fall below recommended levels. Longer TT is associated with better blood pressure control, toxin removal, and metabolic parameters, yet longer treatments can be burdensome to patients. We aimed to update the evidence on TT and hospitalizations in a large, nationally representative, contemporary cohort of in-center HD patients.
Methods
A retrospective cohort of adult, chronic in-center HD patients dialyzing at Fresenius Kidney Care (FKC) clinics between 1/1/2022 and 7/1/2023 was analyzed. The first HD treatment within that time frame was defined as the start of a 30-day exposure period during which mean delivered TT and other baseline characteristics were assessed. Patients with mean delivered TT <3 or >4:30 hours were excluded. After the exposure period, patients were followed for hospitalizations until death, censoring (transplant, modality change, left FKC) or end of 1-year follow-up. A Cox proportional hazards model adjusted for age, sex, race, body mass index, and access type was used to estimate hazards ratios for TT groups.
Results
Among the 141,397 HD patients, the most frequently delivered TTs fell within 3:45 and 3:59 hours. Patients with TT ≥3:30 hours had significantly fewer hospitalizations compared to patients with TT 3-3:14 hours (Table 1). After controlling baseline confounders, TT of 3:30-3:44, 3:45-3:59, 4-4:15, 4:15-4:29 hours associated with reductions in hospitalization rates of 6%, 8%, 16%, and 4%, respectively. These rate differences equate to 10, 13, 26 and 6 averted hospitalizations per 100 person years for 3:30-3:44, 3:45-3:59, 4-4:15, 4:15-4:29 groups, respectively, compared to the 3-3.14 group.
Conclusion
Patients with delivered TT 3:30 to 4:29 hours experienced significantly lower hospitalization rates when compared to patients with delivered TT between 3:00 and 3:14 hours.
Funding
- Commercial Support – Renal Research Institute