Interdialytic Weight Gain in Hemodialysis Patients: Worse Hospital Admissions and Intradialytic Hypotension

摘要

Introduction: Interdialytic weight-gain (IDWG) has been linked to various complications in hemodialysis (HD) patients. Method: Prospective clinical-observational study to evaluate the effect of IDWG in HD patients on the rate of hospital admissions over a 12-month period, and the impact of high IDWG on the frequency of IDH. Results: Of the 240 patients, those who had IDWG ≥ 4%, 81% had at least one hospital admission due to volume-overload or the need for extra HD-session(s). On the other hand, only 19% of those having IDWG < 4% had been admitted or got extra HD sessions (p < 0.001). Of those who were admitted (over 12 months) due to volume overload; 74.1% had IDWG ≥ 4%, while 25.9% had IDWG < 4% (p < 0.001). Regarding IDH, 87% of patients having IDWG ≥ 4% had at least one episode of IDH/week. On the other hand, only 22.5% of those with IDWG < 4% had one episode of IDH/week (p < 0.001). When analyzing those who had at least one IDH episode/week; 72.9% of them had IDWG ≥ 4%, while only 27.1% had IDWG < 4% (p < 0.001). Conclusion: In HD patients, the frequency of hospital admission due to volume-overload and the need for extra HD-sessions is strongly related to the amount of IDWG (>4% in our patients), the same stands for the frequency of IDH. Thus, control of IDWG in HD patients is of great importance, keeping in mind the importance of the nutrition status of HD patients that may also impact IDWG.