Abstract: FR-PO0495
Association Between Percent Body Fat and Intradialytic Hypertension: The Mediating Role of Fluid Balance
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
Author
- Yang, Yaqin, Rijksuniversiteit Groningen, Groningen, GR, Netherlands
Background
This study aimed to explore the association between percent body fat (PBF) and intradialytic hypertension (IDHTN) in maintenance hemodialysis (MHD) patients, with a focus on the mediating role of fluid balance as measured by the extracellular water-to-total body water ratio (ECW/TBW).
Methods
A cross-sectional study was conducted among 208 MHD patients at Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. Body composition was measured using the InBody 770 analyzer, and IDHTN was defined as a systolic blood pressure (SBP) increase of ≥10 mmHg to >140 mmHg in ≥4 of 6 sessions. Logistic regression models evaluated the association between PBF quartiles and IDHTN. Mediation analysis using structural equation modeling assessed the indirect effect of PBF on IDHTN through ECW/TBW, while receiver operating characteristic (ROC) curve analysis evaluated the model's diagnostic performance.
Results
Among 208 participants (55.3% male, median age 62 years), 41 (19.7%) experienced IDHTN. Logistic regression showed an inverse PBF-IDHTN association (OR=0.07 for Q4 vs. Q1, 95% CI: 0.01–0.36, P for trend=0.002). Mediation analysis revealed that ECW/TBW accounted for 12% of this association (P < 0.05). The ROC model incorporating both PBF and ECW/TBW demonstrated an improved diagnostic performance, with an area under the curve (AUC) of 0.813.
Conclusion
Lower PBF was significantly associated with an increased risk of IDHTN in MHD patients, with ECW/TBW partially mediating this relationship. These findings suggest that body composition, particularly fat distribution, may play a critical role in IDHTN pathogenesis, highlighting the importance of volume management in this population.
ROC curves of PBF and multivariate model to predict the risk of IDHTN.
Funding
- Clinical Revenue Support