Abstract: TH-OR089
Changes in Dialysate Prescription and Serum Electrolytes After Transition to Hemodiafiltration with AutoSub Plus in a US Maintenance Dialysis Population
Session Information
- Rethinking Hemodialysis: Innovation Across the Care Continuum
October 22, 2026 | Location: Mile High Ballroom 1A, Convention Center
Abstract Time: 05:40 PM - 05:50 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Van Zandt, Carly R., Renal Research Institute, New York, New York, United States
- Ficociello, Linda, Renal Research Institute, New York, New York, United States
- Zhou, Meijiao, Renal Research Institute, New York, New York, United States
- Chen, Ming, Renal Research Institute, New York, New York, United States
- Stuard, Stefano, Fresenius Medical Care, Pignano, Italy
- Chatoth, Dinesh K., Fresenius Medical Care, Waltham, Massachusetts, United States
Background
Hemodiafiltration (HDF) has only recently become available in the United States, and limited data exist regarding real-world changes in dialysate prescription and pre-dialysis laboratory parameters following transition from HD to HDF.
Methods
We performed a retrospective analysis of 65 maintenance dialysis patients transitioning from HD to HDF with AutoSub Plus (HDF AS+) from October 2025 through April 2026. Eligible patients remained on HDF for >=60 days, with >=80% of follow-up treatments delivered as HDF. Because patients often underwent manual substitution volume ramp-up before HDF AS+ initiation, the 30 days immediately preceding HDF AS+ initiation were excluded. HD period was defined using days -120 to -31 and HDF period using days 0 to +89 relative to HDF AS+ initiation. Serum potassium, bicarbonate, calcium, and dialysate prescriptions were evaluated and compared between HD vs HDF period using paired t-tests.
Results
Changes in dialysate prescriptions and corresponding serum laboratory values are summarized in Table 1. Transition to HDF AS+ was associated with increased dialysate potassium and calcium prescriptions and lower dialysate bicarbonate prescriptions (all p<0.001). Pre-dialysis serum potassium increased (4.81 ± 0.59 vs 5.09 ± 0.46 mEq/L, p<0.001), while serum bicarbonate decreased (24.88 ± 2.74 vs 22.78 ± 2.32 mEq/L, p<0.001). Serum calcium did not significantly change (8.95 ± 0.71 vs 8.90 ± 0.55 mg/dL, p=0.340).
Conclusion
Transition to HDF with AutoSub Plus was accompanied by changes in dialysate potassium, bicarbonate, and calcium prescriptions and corresponding changes in pre-dialysis serum potassium and bicarbonate concentrations. Such changes may potentially contribute to improved electrophysiologic stability, reduced arrhythmogenic risk, and enhanced hemodynamic tolerance during treatment, in addition to the known improvements in intradialytic hemodynamic stability with HDF.
Funding
- Commercial Support – Fresenius Medical Care; Renal Research Institute, NY