Abstract: FR-PO0497
Positive Clinical Outcomes for In-Center Nocturnal Patients Observed in Certain Subgroups
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
- Ryan, Claire, DaVita Inc, Denver, Colorado, United States
- Sibbel, Scott, DaVita Inc, Denver, Colorado, United States
- Shapiro, Mark H., DaVita Inc, Denver, Colorado, United States
- Cassin, Michelle, DaVita Inc, Denver, Colorado, United States
- Naljayan, Mihran V., DaVita Inc, Denver, Colorado, United States
- Weinhandl, Eric D., DaVita Inc, Denver, Colorado, United States
- Brunelli, Steven M., DaVita Inc, Denver, Colorado, United States
Background
In-center nocturnal hemodialysis (INHD) allows for a longer treatment time than the usual 4-hour in-center hemodialysis (ICHD) regimen prescribed in the United States. However, there is limited evidence of reduced hospitalization rates with the more intensive nocturnal dialysis treatments. In this study, we sought to identify distinct groups within the INHD population and then evaluate the hospitalization rate amongst these groups within the INHD population vs. matched ICHD patients.
Methods
Electronic health records were used to identify adult (18+) patients starting INHD between Jan 1, 2022 and Jul 31, 2024 at a kidney care organization. Facilities with ≤2 INHD patients were excluded. Following k-means clustering, three distinct patient types were identified in the INHD cohort: 1) oldest with high BMI, frequently diabetic with post weight above target weight, and hypotension (“high-BMI diabetics”); 2) younger, lower BMI, longer vintage, high UFR (early-onset kidney failure); and 3) younger, clinically unremarkable, shorter vintage (nocturnal “by preference”). INHD patients of each type were then (separately) matched 1:1 to similar patients undergoing ICHD. Formal hospitalization comparisons (incidence rate ratios) were estimated using a generalized linear mixed model with a Poisson distribution and adjusted for covariates.
Results
After matching, results indicate that INHD was nearly significantly associated with a lower hospitalization rate [IRR: 0.79 (0.61,1.02)] among those who pursue INHD “by preference” (group 3). No difference in hospitalization rates was seen amongst the “high BMI diabetics” (group 1) [IRR: 0.99 (0.69, 1.40)]; no comparison was made for group 2 due to small sample size.
Conclusion
Among matched patients, those who pursue in-center nocturnal hemodialysis by choice may have fewer hospitalizations than those on ICHD.