Abstract: SA-PO423
Changes in Fluid Overload during the First 6 Months of Dialysis among More than 13,000 Patients
Session Information
- Hemodialysis and Frequent Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Wolf, Melanie, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Ficociello, Linda, Fresenius Medical Care, Waltham, Massachusetts, United States
- Zhou, Meijiao, Fresenius Medical Care, Waltham, Massachusetts, United States
- Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
- Stuard, Stefano, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care, Waltham, Massachusetts, United States
Background
Fluid overload (FO) is a recognized risk factor for mortality in dialysis patients; however, less has been reported on factors related to changes in FO. Whole-body bioimpedance spectroscopy (BIS) has been validated for hydration assessment. We used Body Composition Monitor (BCM) data, a whole-body BIS, to evaluate changes in the degree of FO during the first 6 months of hemodialysis (HD) or hemodiafiltration (HDF) and characteristics associated with those changes.
Methods
Data was extracted from the global anonymized dialysis database, Apollo Dial DB. All patients with 2 BCM measurements separated by ~6 months, with the first being ≤90 days after HD/HDF start, were included. FO was dichotomized at ≥2.5L overhydration (OH) or at ≥15%/≥13% (for men and women, respectively) OH adjusted for extracellular water (OH/ECW). The patients were grouped into four groups (FO-FO, FO-No overload (NO), NO-FO, and NO-NO) by change in OH in liters (OH-L) and OH relative to ECW (OH-%) between these two measurements.
Results
A total of 13,221 adult HD/HDF patients were included who started dialysis treatment in 2018 or 2019. Baseline characteristics by change in fluid status (OH-L and OH-%) are shown in table 1. There was consistency between both methods of FO definition. Among patients starting with FO (n=8,147/8,354), 40%/37% were not FO at 6 months, for OH-L and OH-%, respectively. The two groups with FO at 6 months, were on average, older and diabetes was more prevalent.
Conclusion
In this first descriptive analysis, we observed improvement in many patients’ fluid status within the first 6 months after initiating HD/HDF. Further research is needed to evaluate whether improvement in FO is associated with better patient outcomes.
Funding
- Commercial Support – Fresenius Medical Care