Abstract: SA-PO1095
Continuous Relative Blood Volume Analysis Reveals Patient-Specific Plasma Refill Profiles
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
Authors
- Meigel, Felix J., Renal Research Institute, New York, New York, United States
- Casper, Sabrina, Renal Research Institute, New York, New York, United States
- Winter, Anke, Renal Research Institute, New York, New York, United States
- Yueh, Sheng-Han, Renal Research Institute, New York, New York, United States
- Zhang, Hanjie, Renal Research Institute, New York, New York, United States
- Ho, Kevin, Fresenius Medical Care North America, Boston, Massachusetts, United States
- Fuertinger, Doris H., Renal Research Institute, New York, New York, United States
Background
Hemodialysis requires substantial fluid removal, which may reduce intravascular volume. Plasma refill rate (PRR) offsets ultrafiltration-related volume loss, reducing intradialytic hypotension risk. Yet, PRR variability remains poorly characterized. Using Crit-Line monitoring (Fresenius Medical Care North America, Waltham, MA), patient-level PRR trajectories were derived from ultrafiltration rate (UFR) and continuous hematocrit (Hct) measurements. We developed a segmentation approach to assess patient-level PRR variability and identify PRR profiles.
Methods
We analyzed 13,214 patients contributing up to 24 hemodialysis treatments (Jan 2022–Apr 2024). We restricted analyses to treatments with constant UFR. PRR was derived from UFR and RBV changes from Hct. Hct trajectories were segmented to identify stable refill periods, defined as intervals with constant PRR. For each treatment, we calculated the mean duration of stable refill periods. Patient-level consistency was assessed using intraclass correlation coefficients (ICCs), pairwise treatment differences, and demeaned stable refill duration–UFR variability.
Results
After restricting to treatments with constant UFR, 12,113 patients contributed a median [Q1, Q3] of 6 [3, 9] treatments. Plasma refill behavior was more consistent within than between patients. Stable refill duration differed less within than between patients (median [Q1, Q3] 2.1 [1.0, 4.2] vs 3.6 [1.6, 6.8] min), suggesting patient-specific PRR patterns. Mean stable refill duration showed substantial patient-level consistency (ICC 56.7%), with more than half of variability occurring between patients. Similar ICCs were observed for mean PRR (63.2%) and UFR (63.3%).
Conclusion
Segmentation of RBV trajectories identified stable plasma refill behavior and revealed unique distinguishable patient-specific patterns. Plasma refill dynamics may reflect intrinsic patient characteristics and support individualized volume-management assessment during hemodialysis.
Funding
- Commercial Support – Fresenius Medical Care