TEMPORAL CHANGE IN ULTRAFILTRATION RATE IN HAEMODIALYSIS PATIENTS OVER A THREE-MONTH PERIOD
Dr Estelle Sultana1, Dr Qiaoran Tu2, Dr Benjamin Hunt1, A/Prof Matthew A Roberts1,3
1Eastern Health Integrated Renal Service (EHIRS), Box Hill, Australia, 2Austin Health, Heidelberg, Australia, 3Eastern Health Clinical School, Monash University, Box Hill, Australia
Aim: To ascertain whether ultrafiltration rate (UFR) changes over a three-month period in people receiving haemodialysis (HD).
Background: High UFR is associated with greater all-cause and cardiovascular mortality, increased intradialytic hypotension, and loss of residual kidney function. A level of 13mL/hour/kg has been reported as a risk-threshold. There is minimal data regarding medium-term changes of UFR over time.
Methods: We measured HD session parameters over six consecutive dialysis sessions in two collection periods, 3-4 months apart, and calculated the average UFR (mL/h/kg). The difference in UFR distribution between time periods was compared with a paired-sample Wilcoxon test. Differences between means of gender and diabetes groups at collection period one was compared with an independent t-test.
Results: Of 191 patients (females=72, males=119) who completed both collection periods (“P1” and “P2”) the mean (±standard deviation (SD)) of P1 and P2 UFRs was 5.73 (±2.43)mL/h/kg and 5.49(±2.39)mL/h/kg, respectively, with a median [IQR] difference of 0.06 [-0.72,1.15]mL/h/kg (p=0.12). Although the median difference was not significant, 24 patients (13%) had a UFR decrease from P1 to P2 >2mL/h/kg, whilst 7 (4%) had a UFR increase >2 mL/h/kg from P1 to P2. In total, 22 of the 2251 individual sessions measured had a UFR >13mL/h/kg, and one patient had a UFR average >13 mL/h/kg (in P2). At P1, males had a UFR mean(±SD) of 5.66 (±2.24)mL/h/kg and females 5.86 (±2.72)mL/h/kg (p=0.60); people with diabetes had a UFR mean of 5.78 (±2.38)mL/h/kg and those without diabetes 5.70 (±2.47)mL/h/kg (p=0.81).
Conclusion: We demonstrated no significant difference in mean UFR of six sessions over 3-4 months. Despite relatively low mean UFR in our patients, some patients required >13 mL/h/kg UFR at some sessions.
Biography:
Dr Estelle Sultana is a current intern at Eastern Health. Having only recently graduated from Monash University Medical School in 2023, she is keen to continue to develop her research skills in the medical field. She has previously completed work as a project officer for the Australian & New Zealand Intensive Care Society (ANZICS).