Open AccessHemodynamic and Laboratory Changes during Incremental Transition from Twice to Thrice-Weekly Hemodialysis
Author(s) -
In-Kyong Hur,
Cachet Wenziger,
Yoshitsugu Obi,
Hamid Reza Moradi,
Elani Streja,
Ekamol Tantisattamo,
Soo Jeong Choi,
Wei Ling Lau,
Ying Chang,
Anna Jin,
Joline L.T. Chen,
Csaba P. Kövesdy,
Connie M. Rhee,
Kamyar Kalantar-Zadeh
Publication year - 2020
Publication title -
cardiorenal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.661
H-Index - 21
eISSN - 1664-3828
pISSN - 1664-5502
DOI - 10.1159/000504383
Subject(s) - medicine , hemodialysis , hemodynamics , weight gain , dialysis , blood pressure , cardiology , body weight
Objective: Incremental hemodialysis (HD) is a strategy utilized to gradually intensify dialysis among patients with incident end-stage renal disease. However, there are scarce data about which patients’ clinic status changes by increasing treatment frequency. Methods: We retrospectively examined statistically de-identified data from 569 patients who successfully transitioned from twice- to thrice-weekly HD (2007–2011) and compared the differences in monthly-averaged values of hemodynamic and laboratory indices during the 3 months before and after the transition with the values at 1 month prior to transition serving as the reference. Results: At 3 months after transitioning from twice- to thrice-weekly HD, ultrafiltration volume decreased by 0.5 (95% CI 0.3–0.6) L/session among 189 patients (33%) with weekly interdialytic weight gain (IDWG) ≥5.4 kg/week, and increased by 0.4 (95% CI 0.3–0.5) L/session among 186 patients (33%) with weekly IDWG <3.3 kg/week. Weekly IDWG consistently increased after the transition irrespective of baseline values (1.7 [95% CI 1.5–1.9] kg/week). Pre-HD systolic blood pressure (SBP) decreased by 12 (95% CI 9–14) mm Hg among 177 patients (31%) with baseline pre-HD SBP ≥160 mm Hg, which coincided with a decreasing trend in post-HD body weight (1.3 [95% CI 0.8–1.7] kg). Discussion: In conclusion, patients who increased HD frequency from twice to thrice weekly treatment experienced increased weekly IDWG and better pre-HD SBP control with lower post-HD body weight.