Abstract: FR-PO0463
Relative Blood Volume Monitoring as Part of a Fluid Management Quality Improvement Project: Six Months Before and After a Retraining Pilot
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
- Ficociello, Linda, Renal Research Institute, New York, New York, United States
- Richards, Monica M, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Gibson, Robin, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Lasky, Rachel A., Renal Research Institute, New York, New York, United States
- Chatoth, Dinesh K., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
Background
Real-time monitoring of relative blood volume (RBV) during hemodialysis (HD) gives insight into the fluid status of a patient. Understanding of the measurement and interpretation of RBV is needed to improve patients’ fluid management. Over time refresher training may be needed for clinics (e.g. explain new device features, new staff, documentation changes). This project assesses a quality improvement project pilot to retrain RBV monitoring using an individualized approach to address specific needs of the clinic.
Methods
CLiC (Crit-Line in a Clip) devices are 510(k) cleared fluid management monitoring tools designed to non-invasively measure absolute hematocrit, oxygen saturation, and RBV during dialysis. These devices have been used as part of a fluid management program at Fresenius Kidney Care. Recently, chronic hemodialysis clinics were chosen to participate in a retraining program. Use of RBV, ending RBV, and number of estimated dry weights (EDW) per patient were averaged over the clinics 6 months before and after retraining.
Results
There were 99 clinics that completed virtual or in-person retraining on RBV. Most trainings were virtual and common themes included documentation, plasma refill, and Crit-Line profile boundary guidance. There were 253,978 HD treatments before and 295,528 after. Overall, clinics averaged 79% and 85% completed RBV orders for all HD treatments before and after retraining, respectively. Median end of treatment RBV decreased from -7.9 [-11.3, -4.3] to -8.20 [-11.5, -4.6] indicating more RBV change. Overall, the average number of EDW changes per patient was 0.98 before and 1.21 after training (23% increase).
Conclusion
A retraining program on RBV focused on the individual needs of the dialysis clinic, was associated with increased use, more change in RBV, and more frequent adjustments in EDW.
Funding
- Commercial Support – Fresenius Medical Care