Abstract Introduction: In maintenance hemodialysis (HD) patients, low central venous oxygen saturation (ScvO2 ) and small decline in relative blood volume (RBV) have been associated with adverse outcomes. Here we explore the joint association between ScvO2 and RBV change in relation to all-cause mortality. Methods: We conducted a retrospective study in maintenance HD patients with central venous catheters as...

Abstract Background: In maintenance hemodialysis patients, intradialytic hypotension (IDH) is a frequent complication that has been associated with poor clinical outcomes. Prediction of IDH may facilitate timely interventions and eventually reduce IDH rates. Methods: We developed a machine learning model to predict IDH in in-center hemodialysis patients 15-75 min in advance. IDH was defined as systolic blood...

Abstract Rationale & objective: People with end-stage kidney disease (ESKD) have very low physical activity, and the degree of inactivity is strongly associated with morbidity and mortality. We assessed the feasibility and effectiveness of a 12-week intervention coupling a wearable activity tracker (FitBit) and structured feedback coaching versus wearable activity tracker alone on changes in physical...

Abstract Background: We hypothesized that the association of ultrafiltration rate with mortality in hemodialysis patients was differentially affected by weight and sex and sought to derive a sex- and weight-indexed ultrafiltration rate measure that captures the differential effects of these parameters on the association of ultrafiltration rate with mortality. Methods: Data were analyzed from the US Fresenius...

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Abstract Background: Nonadherence to hemodialysis appointments could potentially result in health complications that can influence morbidity and mortality. We examined the association between different types of inclement weather and hemodialysis appointment adherence. Methods: We analyzed health records of 60,135 patients with kidney failure who received in-center hemodialysis treatment at Fresenius Kidney Care clinics across the Northeastern US...

Abstract Background: Attaining the optimal balance between achieving adequate volume removal while preserving organ perfusion is a challenge for patients receiving maintenance hemodialysis. Current strategies to guide ultrafiltration are inadequate. Methods: We developed an approach to calculate plasma refill rate throughout hemodialysis using hematocrit and ultrafiltration data in a retrospective cohort of patients receiving maintenance hemodialysis at...

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Abstract Introduction: Several factors affect the survival of End Stage Kidney Disease (ESKD) patients on dialysis. Machine learning (ML) models may help tackle multivariable and complex, often non-linear predictors of adverse clinical events in ESKD patients. In this study, we used advanced ML method as well as a traditional statistical method to develop and compare the...