#3124 Interdialytic weight gain and cardiac geometry in hemodialysis patients

Abstract Background and Aims Interdialytic weight gain is known as a marker of volume overload in hemodialysis patients. Chronic volume overload is associated with cardiovascular changes that may compromise the clinical status of patients and significantly affect their survival. This study aims to find correlations between interdialytic weight gain and changes in cardiac geometry and function in hemodialysis patients. Method A cohort of 138 ESKD patients on hemodialysis under treatment from a single hemodialysis center participated in this study. Interdialytic weight gain, laboratory, echocardiographic data were obtained throughout 2023–2024. Univariate and multivariate logistic regression analysis, ROC curve analysis were used. Results Mean age of patients was 61.9 years ±12.6, 56.5% were male, median time on dialysis was 65.5 months and median IDWG 3.9%. Hypertension was found in 77.5% of cases, Diabetes mellitus in 29%, and ischemic cardiomyopathy in 15.9% of patients. Median dialysis time was 65.5 months which varied from 4–264 months. Significant correlation was found between the mean values ​​of IDWG and tricuspid regurgitation (P = 0.01). A significant and independent predictor factor for tricuspid regurgitation was high IDWG, low renal residual function, high PASP, low ejection fraction; According to ROC curve analysis, the 4.25% cut-off value of IDWG would predict Left Ventricular Hypertrophy with 74.7% sensitivity and 47.2% specificity. Significant and independent predictive factor for left ventricular hypertrophy resulted: old age, Gender (men), high IDWG, hypertension, hyperphosphatemia, hyperparathyroidism. Conclusion These findings emphasize the importance of interdialytic weight management through fluid and dietary sodium restriction as well as by careful individualisation of ultrafiltration according to metabolic needs and specifics of volume control (renal residual function, IDWG, hemodynamic variations) in order to improve cardiovascular prognosis in these patients. Moreover it is important to rigorously manage mineral-bone disorder, arterial blood pressure, and preserve renal residual function. Inclusion of PAPS and right heart chambers in studies and as a target therapy would help in the improvement of these outcomes in dialysis patients.