Kidney Week

Abstract: PUB163

Changes of Arterial Oxygen Saturation during Hemodialysis

Session Information

• Publication Only

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Wang, Lin-Chun, Renal Research Institute, New York, New York, United States

Lin-Chun Wang, MS

• Nandorine Ban, Andrea, Renal Research Institute, New York, New York, United States

Andrea Nandorine Ban, MSc

• Filardi, Vincent, Renal Research Institute, New York, New York, United States

Vincent Filardi

• Ye, Xiaoling, Renal Research Institute, New York, New York, United States

Xiaoling Ye, PhD, MPH

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko, MD, FASN

• Zhang, Hanjie, Renal Research Institute, New York, New York, United States

Hanjie Zhang, PhD

Background

The study of intradialytic arterial oxygen saturation (SaO₂) in hemodialysis (HD) patients is an under-explored area. We aim to describe the dynamics of SaO₂ in HD patients with arteriovenous (AV) access during HD.

Methods

SaO₂ levels during HD were measured using the Crit-Line monitor (CLM; Fresenius Medical Care, Waltham, MA). CLM measurements were recorded at 10-second intervals and transmitted into Amazon Web Services (AWS) via Apache KAFKA, a real time streaming software. We extracted CLM data between January 2021 and July 2023. CLM values with the following characteristics were deemed implausible and excluded: SaO₂≤ 0 or ≥99.9; hematocrit <15% or >60%. We then excluded the sessions with the standard deviation of SO₂<0.1%, an SaO₂ interquartile range of zero, and sessions less than 60 total minutes of recordings. SaO₂ at HD start was calculated as the mean SaO2 between minutes 5 and 20. SaO₂ at the HD end was calculated as the mean SaO₂ in the last 5-20 minutes. The sessions with less than 5 minutes of measurements either at the start or at the end of the session were filtered.

Results

SaO₂ from over 3 million HD sessions from 49,580 patients with AV access are analyzed. The mean SO₂ at the start was 96.42±3.6% and 96.45±3.75% at the end, indicating an average intradialytic SO₂ increase of 0.03% [95% CI: 0.0289 - 0.0325] (Figure 1).

Conclusion

Our results showed that SaO₂ during HD remain similar at the start and end of HD. These data provide a rich source for future research into SaO₂ and its clinical outcome associations. Exploring intradialytic SaO₂ in depth will offer valuable insights to improve patient care and optimize treatment procedures.

SaO₂, arterial oxygen saturation.