Blood Volume Monitoring Improves Outcomes for Patients Hospitalized With HF

Patients receiving hemodialysis commonly require hospitalization and rehospitalization for heart failure (HF), due, in part, to difficulties associated with accurate assessment of volume as well as incorrect ultrafiltration targets.

Researchers conducted a retrospective study to examine a possible association between incorporating blood volume monitoring (BVM) for patients receiving hemodialysis and hospitalized with HF to inform decisions regarding ultrafiltration and improved clinical outcomes. The researchers reported results of the study at the National Kidney Foundation Spring Clinical Meetings 2025.

The study was conducted at 2 hospitals in Boston, Massachusetts; 1 used BVM routinely and the other did not. Before the availability of BVM, the outcomes at the 2 hospitals were similar. Eligible patients were adults receiving maintenance hemodialysis admitted with exacerbations of HF. The primary outcome of interest was length of index hospitalization. Secondary outcomes were time to decongestion, rates of rehospitalization for HF at 90 and 180 days after initial discharge, and time to rehospitalization for HF. Outcomes were extracted from electronic health records and adjudicated by 2 nephrologists.

The cohort included 278 patients. Mean age was 70 years, 58% were male, and 62% were White. The average length of the index hospitalization was 7 days. After adjustment for baseline characteristics, there was an association between BVM and a shorter length of stay (difference of –2.00 days; 95% CI, –4.20 to –0.30), faster time to decongestion, and lower rates of rehospitalization at both 90 days and 180 days after index discharge.

In conclusion, the authors said, “Incorporating BVM in managing hemodialysis patients with HF was associated with improved clinical outcomes, including shorter length of stay, faster decongestion, and reduced hospitalization rates. These findings support the need for prospective studies to optimize volume management and improve outcomes in this challenging patient population.”

Source: El Mouhayyar C, Al Jurdi A, Tang M, Liu L, Kalim S, Nigwekar S. Comparison of outcomes with and without blood volume monitoring among hospitalized patients with heart failure on maintenance hemodialysis. Abstract #G-295. Presented at the National Kidney Foundation Spring Clinical Meetings 2025; April 10-13, 2025; Boston, MA. doi:10.1053/j.ajkd.2025.02.296