Related Experiment Video
Updated: May 10, 2026
04:36
Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
Modifiable variables affecting interdialytic weight gain include dialysis time, frequency, and dialysate sodium.
Benjamin K A Thomson1, Stephanie N Dixon, Shi-Han S Huang
1Division of Nephrology, Department of Medicine, London Health Sciences Centre and Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada.
Hemodialysis International. International Symposium on Home Hemodialysis
|June 21, 2013
Summary
Interdialytic weight gain (IDWG) is linked to serious health issues. Modifiable factors like dialysis time, frequency, and dialysate sodium can help predict and manage IDWG.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Research
Background:
- Interdialytic weight gain (IDWG) is a significant predictor of adverse outcomes in hemodialysis patients, including hypertension, left ventricular hypertrophy, and mortality.
- Dialysate sodium concentration and dialysis parameters may influence IDWG through sodium diffusion gradients, but these factors have been under-investigated.
Purpose of the Study:
- To identify modifiable factors that predict interdialytic weight gain (IDWG) in patients undergoing home hemodialysis.
- To develop a predictive equation for IDWG based on readily available patient and dialysis parameters.
Main Methods:
- Retrospective analysis of data from 86 home hemodialysis patients.
- Multivariable regression analysis using backwards selection and Akaike information criterion to build a predictive model.
- Internal validation using bootstrapping and external validation in a separate patient cohort.
Main Results:
- Age, diabetic status, and residual renal function were not significant predictors of IDWG in univariable analysis.
- A predictive equation for IDWG was developed, incorporating serum albumin, age, patient sex, dialysis frequency, and the sodium diffusive balance (dialysis duration × plasma-to-dialysate Na+ gradient).
- The developed equation demonstrated internal and external validity.
Conclusions:
- An equation to predict IDWG has been established using independent factors available pre-dialysis.
- Key modifiable factors influencing IDWG include dialysis time, dialysis frequency, and dialysate sodium concentration.
- Further research is needed to determine the clinical impact of improving IDWG on cardiovascular and other outcomes.
Related Concept Videos
01:25Hemodialysis III: Nursing Management
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
01:25Peritoneal Dialysis III: Nursing Management
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:28Chronic Kidney Disease III: Interprofessional Care
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...