Abstract: TH-PO321
Changes in Relative Blood Volume during Hemodialysis: An Extensive US Cohort
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Filardi, Vincent, Renal Research Institute, New York, New York, United States
- Nandorine Ban, Andrea, Renal Research Institute, New York, New York, United States
- Wang, Lin-Chun, Renal Research Institute, New York, New York, United States
- Ye, Xiaoling, Renal Research Institute, New York, New York, United States
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
- Zhang, Hanjie, Renal Research Institute, New York, New York, United States
Background
Specific hourly intradialytic relative blood volume (RBV) ranges are associated with lower all-cause mortality in chronic hemodialysis (HD) patients (Preciado, NDT 2019). However, the intradialytic RBV levels in large US population is unknown. The goal of our research was to fill this knowledge gap by exploring the intradialytic RBV levels at a session level in a large US HD population.
Methods
Hematocrit was measured every 10 seconds during an HD session with the Crit-Line Monitor (CLM; Fresenius Medical Care, Waltham, MA). The CLM then reports the RBV every 10 seconds. Data were uploaded to the cloud in real time. We analyzed CLM data collected from 1/14/2021 to 7/30/2023.
We aggregated RBV values into intervals at 30, 60, 90, 120, 150, 180, 210, and 240 minutes into the HD session. To accomplish this, we averaged the RBV data between 20 and 40 minutes as the 30-minute interval, 50 and 70 minutes as the 60-minute interval, and so on. Sessions with less than 1 hour of data or an average RBV value outside the 90% to 110% range during 5 to 20 minutes into the treatment were excluded. Finally, an interval was excluded if it had less than 5 minutes of data or an average value outside 75% to 115%.
Results
We analyzed 71,984 patients from 719 HD clinics. Over the final 4,798,225 treatment sessions, Figure 1A shows the distribution of intradialytic RBV per 30-minute interval. Figure 1B shows the distribution of treatments relative to the favorable RBV ranges by hours into the HD session.
Conclusion
Our findings indicate, at the session level, a slightly higher prevalence within the favorable hourly RBV ranges, lower prevalence above the ranges, and higher prevalence below the ranges when compared to Preciado (NDT, 2019). We hypothesize that this variation may indicate improved fluid management. The clinical correlates of this finding warrants further research.
Reference:
Preciado P, Zhang H, Thijssen S, Kooman JP, van der Sande FM, Kotanko P. All-cause mortality in relation to changes in relative blood volume during hemodialysis. Nephrol Dial Transplant. 2019 Aug 1;34(8):1401-1408.
Funding
- Commercial Support – Renal Research Institute, New York, NY, a wholly owned subsidiary of Fresenius Medical Care.