Abstract: PO0866
Use of Crit-Line to Reduce Intradialytic Hypotension in Hospitalized Patients Receiving Dialysis
Session Information
- Fluid, Electrolytes, and Clinical Events with Dialysis: Getting to the "Heart" of the Matter
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Martin, Marissa Anne, University of Colorado, University of Colorado, Denver, CO, US, academic/system, Denver, Colorado, United States
- Perez, Luis M., University of Colorado, University of Colorado, Denver, CO, US, academic/system, Denver, Colorado, United States
- Bansal, Anip, University of Colorado, University of Colorado, Denver, CO, US, academic/system, Denver, Colorado, United States
- Kendrick, Jessica B., University of Colorado, University of Colorado, Denver, CO, US, academic/system, Denver, Colorado, United States
Background
Intradialytic hypotension (IDH) is a frequent complication of hemodialysis (HD) in hospitalized patients with acute kidney injury (AKI) and end stage kidney disease (ESKD). Crit-Line is a device that monitors absolute hematocrit and oxygen saturation during dialysis and reads out the percent blood volume change. Whether the use of Crit-Line during HD in hospitalized patients results in less IDH is unknown.
Methods
We performed a time series study in all hospitalized adult AKI/ESKD patients undergoing acute HD at the University of Colorado. During the control period baseline data was collected. During the intervention period, Crit-Line was used on all hospitalized patients undergoing HD including those receiving portable HD treatments in the ICU. During both time periods, nurses recorded number of hypotensive events, patient symptoms and modifications that were made to the dialysis prescription. The primary outcome was number of IDH events defined by the NKF KDOQI Guidelines.
Results
328 patients were included, 161 from the control period and 167 from the intervention period. Patient characteristics were similar in both time periods and are shown in Table 1. IDH occurred in 23.5% of treatments during the control period and 18.7% during the intervention period, but the difference was not significant, p=0.22 (Figure 1). When examining portable dialysis treatments in the ICU, there was a significant reduction in IDH with Crit-Line compared to control (Odds Ratio 0.71 95% CI 0.51-0.99, p=0.04).
Conclusion
Use of Crit-Line in hospitalized patients undergoing dialysis in the ICU resulted in less IDH.
| Control Period (n=161) | Crit-Line Period (n=167) | |
| Age (years) | 56.9 ± 15.0 | 56.2 ± 15.0 |
| Female N(%) | 68 (40.7) | 66 (41.3) |
| Race White N(%) | 82 (50.9) | 86 (51.5) |
| ESKD N(%) | 114 (70.8) | 120 (71.9) |
| Diabetes N(%) | 84 (52.2) | 81 (48.5) |
| ICU N(%) | 33 (20.5) | 39 (23.4) |
| Number of dialysis treatments N(%) | 357 (52.7) | 321 (47.4) |
Funding
- Commercial Support – Fresenius Renal Therapies