Abstract: SA-PO1114
Inadequate Hemodialysis: Implementation of Early Notification System and Its Effect on Dialysis Adequacy
Session Information
- Kidney Replacement Therapy and Care Delivery Innovations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Author
- Navarrete, Jose E., Emory University, Atlanta, Georgia, United States
Background
Providing adequate hemodialysis, as defined by a single pool Kt/V of at least 1.2, has been the cornerstone of adequacy in patients receiving hemodialysis. An adequate dialysis relies on a complex interplay of dialysis time, ultrafiltration, filter size selection, vascular access functionality and patient adherence to treatment. Achieving adequate dialysis also impacts payments to dialysis providers as it is one of the clinical performances monitored in the CMS-QIP program. The National average of hemodialysis patients achieving adequate Kt/V is 96% as of May 2026.
Methods
This project was implemented at Emory Dialysis Centers in Atlanta, caring for ~650 hemodialysis patients per month. Starting on February 2025, treating physicians were notified early in the month if patients under their care were not meeting adequacy. The notification included the Kt/V with the date of testing, prescribed time, achieved dialysis time and the filter used. No suggestions on how to optimize adequacy were made. Since implementation of the notification system we monitored the percentage of patients achievieng a Kt/V >1.2 and number of patients in whom prescribed time was increased. Patients were followed thought 2025.
Results
At baseline (January 2025), before implementation of the program, the percentage of patients achivieving adequate Kt/V at the end of the month was 97.2%. Once the program was implemented the percentage of patients achieving the goal increased progressively and has reached consistent values above 99% (Figure 1A). At baseline, the percentage of patients who had their dialysis prescribed time updated was 0.8%/month. After implementation of the program, the number of patients with an increase in prescribed time increased significantly (Figure 1B).
Conclusion
A notification system alerting physicians of inadequate Kt/V resulted in a consistently higher percentage of patients achieving adequate hemodialysis. The number of patients with increased in prescribed time changed in parallel to the increase in Kt/V.