Kidney Week

Abstract: TH-PO0858

Intradialytic Changes of Upper Body Blood Flow (UBBF) and UBBF-Derived Cardiac Power Output: Findings in a Large Population of Patients on Hemodialysis with Central Venous Catheter as Vascular Access

Session Information

• Dialysis: Prescription, Physiology, and Treatment Optimization
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Yueh, Sheng-Han, Renal Research Institute, New York, New York, United States

Sheng-Han Yueh, MS

• Usvyat, Len A., Renal Research Institute, New York, New York, United States

Len A. Usvyat, PhD, FASN

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko, MD, FASN

• Zhang, Hanjie, Renal Research Institute, New York, New York, United States

Hanjie Zhang, PhD

Background

Hemodialysis (HD) patients face significant cardiovascular stress, with high mortality rates linked to intradialytic hypotension and hemodynamic instability (Chan L et al., Sci Rep. 2017). Estimated upper body blood flow (eUBBF) reports blood flow in the vascular bed draining into the superior vena cava. Cardiac power output derived from eUBBF (CPO_eUBBF) integrates both flow and arterial pressure, reflecting cardiac performance. To better understand their intradialytic hemodynamic changes, we evaluated patient-level start-to-end changes of eUBBF and CPO_eUBBF.

Methods

We studied a retrospective cohort of 19,887 patients with ≥10 treatments lasting ≥3 hours, comprising 1,054,379 treatments across 640 clinics (years 2021–23). eUBBF was calculated as recently described (Rosales LM, et al., Blood Purif. 2019). CPO_eUBBF (in Watts) was calculated as eUBBF (L/min) × mean arterial pressure (mmHg) / 451. We report patient-level eUBBF and CPO_eUBBF at dialysis start and end, and their respective changes.

Results

At the patient level, mean (±SD) eUBBF decreased from 1.36±0.46 to 1.18±0.42 L/min (−13.3%; 95% CI: −13.48% to −13.12%). CPO_eUBBF declined from 0.3±0.11 to 0.25±0.1 W (−15.11%; 95% CI: −15.34% to −14.88%).

Conclusion

The observed reductions of ~13% in eUBBF and ~15% in CPO_eUBBF are clinically significant, especially in patients with congestive heart failure and limited cardiovascular reserve. Our methods provide continuous point-of-care insights into patient hemodynamics. Further studies are warranted to explore the associations of eUBBF and CPO_eUBBF with clinical outcomes.

Acknowledgment

Artificial intelligence tools were used to assist in the writing of this abstract. The authors reviewed and edited the content and take full responsibility for the final version.

Funding

• Commercial Support – Fresenius Medical Care