DaVita Medical Insights

Study: Ultrafiltration Profiling: Association with Clinical Outcomes among Incident Dialysis Patient

Ultrafiltration (UF) profiling is the practice of varying the UF rate during the dialysis treatment in order to mitigate the consequences of decreased effective circulating volume. In practice, UF profiling may be used on a standing basis, an as-needed basis or not at all. In an effort to determine whether there was greater benefit with one specific approach, DaVita Clinical Research conducted a parallel, matched analysis that compared standing UF profiling to as-needed profiling and to no profiling.

Overall, the analysis found that there was no clear and consistent benefit to the use of UF profiling. For example, no UF profiling (versus standing UF profiling) was associated with slightly lower rates of intradialytic hypotension and hospitalization, but indistinguishable rates of death and missed treatments. However, as-needed UF profiling (versus standing UF profiling) was associated with lower rates of intradialytic hypotension, but higher rates of hospitalizations and missed treatments.

Standing UF profiling did not appear to provide a greater benefit than no UF profiling, and as-needed UF profiling did not appear to be superior to standing UF profiling. These data called into question the rationale for the commonplace use of UF profiling in clinical practice. Unfortunately, data limitations precluded studying the impact of UF profiling in patients with residual renal function. Furthermore, this analysis was restricted to incident patients to minimize confounding by indication. The applicability of these results to prevalent patients is not known.

For more information, read the research poster (which was presented at ASN) here.

 

Managing Editor