P1500SEASONAL VARIATIONS AND VARIATIONS DUE TO OTHER CAUSES IN CLINICAL AND LABORATORY PARAMETERS IN HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims In hemodialysis patients, seasonal variations and changes in dialysis prescription affect laboratory data, blood pressure, and body weight. We examined whether these fluctuations were due to seasonal variations or other causes. Although there are some reports on seasonal changes in hemodialysis patients, there are few reports on observations over multiple years in the same stable patients. Method We studied 65 patients on hemodialysis (36 males and 29 females; average age, 67.7 years; average duration of HD therapy, 13.8 years). The observation period was three years from January 2016 to December 2018; laboratory data and dialysis-related indicators, blood pressure, dry weight, and interdialysis weight gain were examined retrospectively. We excluded cases with dialysis time less than 4 h and patients who were hospitalized during the observation period. Differences in statistical analysis were tested with repeated-measures ANOVA or Friedman test. Results Factors that showed an influence on the laboratory parameters in hemodialysis patients more than twice in the same season in the three-year observation period were serum urea nitrogen (UN), serum creatinine (Cr), serum potassium (K), serum inorganic phosphorus (IP), and serum total bilirubin (T-Bil), serum creatine kinase (CPK), serum glycoalbumin (GA), normalized protein catabolic rate (nPCR), % creatinine production rate (% CGR), systolic blood pressure (sBP), diastolic blood pressure (dBP), and inter-dialytic weight gain (p<0.05). In contrast, the serum albumin concentration (Alb), serum magnesium (Mg), serum parathyroid hormone-INTACT (iPTH), and standardized dialysis amount of urea (KT/Vurea) exhibited gradual changes during the observation period (p<0.05). Conclusion There were indeed seasonal variations with UN, Cr, K, IP, T-Bil, CPK, GA, nPCR, %CGR, sBP, dBP, and inter-dialytic weight gain. However, Alb, Mg, iPTH, KT/Vurea changed owing to dialysis prescription and medicines.