Kidney Week

Abstract: PUB147

Detrimental Effects of Diet Selection in Hospitalized Patients with ESKD

Session Information

• Publication Only

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Larson, Hanna, Loyola University Medical Center, Maywood, Illinois, United States

Hanna Larson, DO, MS

• Jain, Drishti, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States

Drishti Jain

• Griffin, Karen A., Loyola University Medical Center, Maywood, Illinois, United States

Karen A. Griffin, MD, FASN

• Vellanki, Kavitha, Loyola University Medical Center, Maywood, Illinois, United States

Kavitha Vellanki, MD

Background

End-Stage Renal Disease (ESRD) patients are at increased risk of emergent dialysis and mortality with hyperkalemia (K ≥5.5 mmol/l). There is limited data on outcomes from prescribed diets for hospitalized ESRD patients. Our study aims to evaluate outcomes of medically prescribed diets in hospitalized ESRD patients on maintenance hemodialysis.

Methods

Our study is a single-institution retrospective cohort study (1/2020-12/2023). Exclusion criteria comprised patients with critical illness requiring ICU care, rhabdomyolysis, hyperkalemia or NPO on admission, and receiving bone marrow/stem cell transplant or chemotherapy (associated with cell lysis/K release). Cohort patients were defined by diet prescribed on admission: renal or non-renal diets. Primary outcomes included arrhythmias and additional dialysis for hyperkalemia. Secondary outcomes included additional medications or labs to manage hyperkalemia, and 30-day readmissions.

Results

The 195 study patients had 842 admissions. After applying exclusion criteria, 489 admissions were analyzed. Primary and secondary outcomes are outlined in Table 1. On admission, non-renal diets were prescribed more frequently (Table 1). Hyperkalemia occurred less on renal diets, as did episodes of additional dialysis, and the need for extra medications and labs to manage hyperkalemia. Readmissions within 30 days were less if on a renal diet (Table 1).

Conclusion

Preliminary analysis reveals more interventions occur to manage hyperkalemia in hospitalized ESRD patients prescribed a non-renal diet and readmissions are more frequent. Further studies are needed to understand the risks and outcomes of diet prescription practices in hospitalized ESRD patients to determine steps to improve outcomes.