Predictive factors of hospitalization, comparison between conventional and incremental hemodialysis: Bi-centered retrospective cohort study

Objectives: Chronic kidney disease (CKD) is a common condition that naturally progresses to end-stage renal disease and increasingly requires hemodialysis. Several questions have been raised about the differences between incremental and conventional hemodialysis with respect to the factors influencing the risk of hospitalization. Material and Methods: This is a bicentric retrospective cohort study conducted in two nephrology departments, focusing on hemodialysis patients from January 2018 to January 2023. Results: This study included 127 patients: A first group of 72 conventionally hemodialyzed (56.69%) and a second group of 55 incrementally hemodialyzed (43.30%), with a mean age of 54.97 ± 15.96 years. Men represented 58.3% of the population. Hypertension was present in 71.7% of patients, and 38.6% were diabetic. The initial nephropathies observed were as follows: Diabetic (30.7%), tubulointerstitial (25.2%), undetermined (16.5%), vascular (15%), primary glomerular (11%), and hereditary (1.6%). When comparing the two groups, there was no significant difference in anthropometric measurements. Interdialytic weight gain was significantly higher in group 1 ( p < 0.001). In univariate analysis, the predictive factors for hospitalization were the conventional hemodialysis (HD) method ( p = 0.005), pre-, per-, and post-HD hypertension, inadequate and unsatisfactory HD (respectively p = 10–3, p = 0.004), hyperkalemia ( p = 0.004), and anuria ( p = 0.003). Conclusion: Our results identified risk factors for hospitalization, and conventional hemodialysis was associated with an elevated risk of hospitalization. Therefore, it is crucial to adopt a holistic approach when making therapeutic decisions and to consider these risk factors to identify patients at high risk for hospitalization.