Kidney Week

Abstract: SA-PO1024

Predictors of Sustained Decremental Hemodialysis (dHD): A Comparison of Patients with dHD Duration ≥1 Year vs. <1 Year

Session Information

• Hemodialysis: Risk Factors, Epidemiology, and Outcomes
  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

• Jung, Sehyun, Gyeongsang National University College of Medicine, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Sehyun Jung, MD

• Lee, Seunghye, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Seunghye Lee, MD

• Kim, Sugyu, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Sugyu Kim

• Jeon, Hyejin, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Hyejin Jeon, MD

• Jang, Hani, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Hani Jang, MD, PhD

• Lee, Tae won, Gyeongsang National University College of Medicine, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Tae won Lee, MD, PhD

• Park, Dong Jun, Gyeongsang National University College of Medicine, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Dong Jun Park, MD, PhD

• Kim, Hyun-Jung, Gyeongsang National University College of Medicine, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Hyun-Jung Kim, MD, PhD

• Chang, Se-Ho, Gyeongsang National University College of Medicine, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Se-Ho Chang, MD, PhD

Background

Decremental hemodialysis (dHD) reduces dialysis frequency and/or session duration in patients with preserved residual kidney function (RKF), distinct from incremental HD. Prior studies showed no significant safety difference between dHD and standard thrice-weekly HD. However, predictors of sustained dHD remain poorly defined.

Methods

We retrospectively analyzed 24 dHD-initiated patients (urine output >600 mL/day) at a single center. Sustained dHD was defined as maintenance of dHD for ≥1 year. Patients were stratified into sustained (n=14) and non-sustained groups (<1 year but ≥3 months; n=10). Clinical characteristics, blood pressure profiles, dialysis adequacy, nutritional markers, and laboratory parameters were compared. Univariable logistic regression was performed to identify factors associated with sustained dHD.

Results

No significant differences were observed in age, sex, BMI, dialysis adequacy, or comorbidity burden between groups. The sustained dHD group showed numerically higher urine volume (1384 vs. 1272 mL/day), GNRI (102.9±10.5 vs. 98.4±9.7), and nPNA (1.21±0.40 vs. 1.15±0.30). Pre-to-nadir SBP drop was greater in the sustained dHD group (19.1 vs. 8.9 mmHg, p=0.075), whereas nadir SBP values were similar between groups, suggesting a hemodynamic characteristic rather than intradialytic hypotension. Univariable logistic regression showed trends favoring sustained dHD for pre-to-nadir SBP decline, GNRI, and eGFR by CKD-EPI.

Conclusion

Better nutritional status and preserved RKF may support long-term dHD maintenance. Pre-to-nadir SBP drop reflects hemodynamic characteristics rather than intradialytic hypotension risk. Given the small sample size (n=24), these findings are exploratory and warrant validation in larger prospective studies.