High interdialytic weight gain (IDWG) is associated with adverse outcomes in hemodialysis patients. In a recent paper published in the American Journal of Kidney Diseases, researchers used data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) to identify trends in IDWG, predictors of IDWG, and associations of IDWG with clinical outcomes.
From 2002 to 2014, IDWG declined in US, Canada, and Europe, with more modest declines in Japan and Australia/New Zealand. These reductions are partially explained by reductions in dialysate sodium (DNa): every 1 mEq/L DNa was associated with greater IDWG by 0.13% of post-hemodialysis weight.
The authors found elevated risk of mortality at IDWG ≥5.7% of post-hemodialysis weight and elevated risk of fluid overload hospitalization at IDWG ≥4%. These findings suggest that focusing quality improvement strategies toward reducing high IDWG may improve patient outcomes.
Wong MMY, McCullough KP, Bieber BA, Bommer J, Hecking M, Levin NW, McClellan WM, Pisoni RL, Saran R, Tentori F, Tomo T, Port FK, Robinson BM. Interdialytic Weight Gain: Trends, Predictors, and Associated Outcomes in the International Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2016 Nov 17. [Epub ahead of print]
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November 21, 2016
Lead author Michelle Wong discusses interdialytic weight gain in the United States