Once-per-week haemodialysis in a financial crisis: Predictors of interdialytic weight gain

Background

Several countries are experiencing challenges in maintaining standard haemodialysis services for people with kidney failure.

Objective

This study aimed to investigate the health profile of people receiving haemodialysis and to identify factors associated with interdialytic weight gain.

Design

A cross-sectional study.

Participants

A total of 166 adults with kidney failure and receiving haemodialysis for at least 3 months were included.

Measurements

A structured chart audit form collected, demographic and haemodialysis treatment characteristics, recent biochemical and haematological results, and prescribed treatment regimens from clinical records. Data were analysed descriptively. Odds ratios (OR) were calculated to identify independent risk factors for interdialytic weight gain.

Results

Mean age was 52 years (SD = 12.5), over half were male (60.2%, n = 100), and most were receiving 4 h of haemodialysis once per week (87.3%, n = 145). Approximately half (51.8%, n = 86) had an interdialytic weight gain >2%. Being female (OR = 3.39; 95% CI, 1.51–7.61), increased comorbidities (OR = 1.50; 95% CI, 1.22–1.84) and having BMI outside of the normal range (overweight/obese [OR = 8.49; 95% CI, 3.58–20.13] or underweight [OR = 4.61; 95% CI, 1.39–15.31]) were independent risk factors for increased interdialytic weight gain.

Conclusion

Most patients were receiving 4 h of haemodialysis once per week although only modest alterations in potassium, phosphate, and fluid status were observed. Understanding the patient profile and predictors of interdialytic weight gain will inform the development of self-management interventions to optimise clinician support.