Mihály B Tapolyai1, Mária Faludi1, Klára Berta1, Tibor Szarvas2, Zsolt Lengvárszky2, Miklos Z Molnar3, Neville R Dossabhoy4,5, Tibor Fülöp6. 1. Fresenius Medical Care, Semmelweis University, Budapest, Hungary. 2. Department of Mathematics, Louisiana State University Shreveport, Shreveport, LA, USA. 3. Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. 4. Medical Service, Overton Brooks Veterans' Administration Medical Center, Shreveport, LA, USA. 5. Department of Internal Medicine, Louisiana State University Health School of Medicine, Shreveport, LA, USA. 6. Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, L 504, Jackson, MS, 39216-4505, USA. tiborfulop.nephro@gmail.com.
Abstract
PURPOSE: Interdialytic weight gain (IDWG) is both a measure of dietary compliance and a well-established predictor of future adverse outcomes in dialysis patients. The impact of environmental conditions on IDWG in end-stage renal disease is little studied to date. METHODS: We retrospectively reviewed IDWG for 100 consenting chronic end-stage renal disease patients undergoing thrice weekly in-center hemodiafiltration under three different climatic conditions in a Central European city: Weekend_1 was humid (93 %) and warm (24 °C); Weekend_2 was dry (38 %) and hot (33 °C); and Weekend_3 was dry (30 %) and warm (24 °C). RESULTS: The cohort's mean age was 60.9 ± 14.7 years, all were Eastern European, and 56 % were men. Residual urine output measured 100 [25-75 % quartiles: 0, 612] mL/day, single-pool Kt/V 1.4 ± 0.25, and albumin 40.1 ± 3.9 g/L. Mean IDWGs measured as follows: Weekend_1 ("humid-warm"): 2973 ± 1386 mL; Weekend_2 ("dry-hot"): 2685 ± 1368 mL and Weekend_3 ("dry-warm"): 2926 ± 1311 mL. Paired-samples testing for difference showed higher fluid gains on the humid-warm (239 mL; 95 % CI 21-458 mL; p = 0.032) and on the dry-warm weekends (222 mL; 95 % CI -8 to 453 mL, p = 0.059), when compared to the dry-hot weekend. Under the latter, dry-hot climatic condition, residual urine output lost its significance to impact IDWG during multiple regression analysis. CONCLUSION: While excess temperature may impact IDWG to a small degree, air humidity does not; the least weight gains occurred on the dry-hot weekend. However, the effects of both were minimal under continental summer conditions and are unlikely to explain large excesses of individual session-to-session variations.
PURPOSE:Interdialytic weight gain (IDWG) is both a measure of dietary compliance and a well-established predictor of future adverse outcomes in dialysis patients. The impact of environmental conditions on IDWG in end-stage renal disease is little studied to date. METHODS: We retrospectively reviewed IDWG for 100 consenting chronic end-stage renal diseasepatients undergoing thrice weekly in-center hemodiafiltration under three different climatic conditions in a Central European city: Weekend_1 was humid (93 %) and warm (24 °C); Weekend_2 was dry (38 %) and hot (33 °C); and Weekend_3 was dry (30 %) and warm (24 °C). RESULTS: The cohort's mean age was 60.9 ± 14.7 years, all were Eastern European, and 56 % were men. Residual urine output measured 100 [25-75 % quartiles: 0, 612] mL/day, single-pool Kt/V 1.4 ± 0.25, and albumin 40.1 ± 3.9 g/L. Mean IDWGs measured as follows: Weekend_1 ("humid-warm"): 2973 ± 1386 mL; Weekend_2 ("dry-hot"): 2685 ± 1368 mL and Weekend_3 ("dry-warm"): 2926 ± 1311 mL. Paired-samples testing for difference showed higher fluid gains on the humid-warm (239 mL; 95 % CI 21-458 mL; p = 0.032) and on the dry-warm weekends (222 mL; 95 % CI -8 to 453 mL, p = 0.059), when compared to the dry-hot weekend. Under the latter, dry-hot climatic condition, residual urine output lost its significance to impact IDWG during multiple regression analysis. CONCLUSION: While excess temperature may impact IDWG to a small degree, air humidity does not; the least weight gains occurred on the dry-hot weekend. However, the effects of both were minimal under continental summer conditions and are unlikely to explain large excesses of individual session-to-session variations.
Entities:
Keywords:
Compliance; Fluid overload; Humidity; Residual urine output; Sweating; Temperature
Authors: Alfred K Cheung; Guofen Yan; Tom Greene; John T Daugirdas; Johanna T Dwyer; Nathan W Levin; Daniel B Ornt; Gerald Schulman; Garabed Eknoyan Journal: J Am Soc Nephrol Date: 2002-09 Impact factor: 10.121
Authors: Mihály Tapolyai; Tibor Fülöp; Aşkin Uysal; Zsolt Lengvárszky; Tibor Szarvas; Kathleen Ballard; Neville R Dossabhoy Journal: Am J Med Sci Date: 2010-06 Impact factor: 2.378
Authors: Tibor Fülöp; Minesh B Pathak; Darren W Schmidt; Zsolt Lengvárszky; Julio P Juncos; Christopher J Lebrun; Harjeet Brar; Luis A Juncos Journal: ASAIO J Date: 2010 Jul-Aug Impact factor: 2.872
Authors: Kamyar Kalantar-Zadeh; Deborah L Regidor; Csaba P Kovesdy; David Van Wyck; Suphamai Bunnapradist; Tamara B Horwich; Gregg C Fonarow Journal: Circulation Date: 2009-01-26 Impact factor: 29.690
Authors: Mihály Tapolyai; Mária Faludi; Virág Réti; Zsolt Lengvárszky; Tibor Szarvas; Tibor Fülöp; Gabriella Bekő; Klára Berta Journal: Hemodial Int Date: 2013-01-30 Impact factor: 1.812
Authors: Robert J Ellis; Sharon J Del Vecchio; Benjamin Kalma; Keng Lim Ng; Christudas Morais; Ross S Francis; Glenda C Gobe; Rebekah Ferris; Simon T Wood Journal: Int Urol Nephrol Date: 2018-06-05 Impact factor: 2.370