Effect of Hemodialysis Rounding Report Availability on Hospitalized ESRD Patient Parameters

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Background: Each ESRD patient has a rounding outpatient HD report which is established by the outpatient dialysis unit and contains pertinent information including dry weight (EDW), dialysis prescription, and current medications. In this study, we compared inpatient dialysis-related parameters between 2 groups of patients, those for whom rounding reports were made available and those whose reports were not able to obtain. Methods: The outpatient hemodialysis facility list was available for all healthcare providers. The facilities were contacted to obtain the hemodialysis report for the hospitalized patients with ESRD. The relevant parameters were obtained from these reports, which included hemoglobin, phosphorus, and EDW. The aforementioned identical parameters were monitored during the course of the hospitalization on all ESRD patients. Patients with available outpatient dialysis reports were restarted on the same outpatient doses of Epogen, phosphate binders, and EDW was adjuted to the same outpatient HD EDW. For those who do not have HD report available, their regimen was adjusted based on their clinical parameters. The dry weight was adjusted based on their volume status during the hospitalization. Results: Sixteen ESRD patients admitted to the hospital were included. Upon discharge, those who had outpatient dialysis reports (10 out of 16) had significant improvement of phosphorus levels, better control of the volume status, and no significant changes in hemoglobin. Three out of ten patients developed intradialytic hypotension. The average length of hospitalization was 9 days. Those who didn't have the outpatient dialysis reports available during their hospitalization (6 out of 16) had no significant changes in phosphorus levels, post-dialysis weights, or hemoglobin. Five out of six patients developed intradialytic hypotension. The average length of stay was 10 days. Table 1. Conclusions: Patients who have dialysis rounding reports available to guide their treatment while hospitalized have better dialysis-related parameters than those who don't. - Dialysis report available Dialysis report not available On admission On discharge P Value On admission On discharge P Value phosphorus 6.08 ± 0.4 mg/dl 4.9 ± 0.5 mg/dl 0.004 5.8 ± 0.4 mg/dl 5.6 ± 0.6 mg/dl 0.3 Hemoglobin 9.6 ± 0.5 g/dl 9.34 ± 0.37 g/dl 0.2 10.1 ± 1.16 g/dl 9.15 ± 1.2 g/dl 0.07 Weight 77.9 ± 7.8 kg 74.5 ± 6.8 kg 0.008 90.5 ± 7.5 kg 89.9 ± 6.8 kg 0.4

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