IMPACT OF HYPOPHOSPHATEMIA ON MAINTENANCE HEMODIALYSIS PATIENTS IN THE INTENSIVE CARE UNIT

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Abstract Title *

IMPACT OF HYPOPHOSPHATEMIA ON MAINTENANCE HEMODIALYSIS PATIENTS IN THE INTENSIVE CARE UNIT

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Co-author 1

Sayaka Ishigaki ishigaki@hama-med.ac.jp Hamamatsu University Hospital Blood Purification Unit Hamamatsu Japan *

Co-author 2

Yuri Uchiyama u.yuri@hama-med.ac.jp Hamamatsu University School of Medicine Internal Medicine 1 Hamamatsu Japan -

Co-author 3

Taro Aoki aoki88@hama-med.ac.jp Hamamatsu University Hospital Blood Purification Unit Hamamatsu Japan -

Co-author 4

Naoko Tsuji ntsuji@hama-med.ac.jp Hamamatsu University School of Medicine Internal Medicine 1 Hamamatsu Japan -

Co-author 5

Takamasa Iwakura tkms0421@hama-med.ac.jp Hamamatsu University School of Medicine Preventive Medicine for Severe Progression of Lifestyle-Related Diseases Hamamatsu Japan -

Co-author 6

Shinsuke Isobe isobe58@hama-med.ac.jp Hamamatsu University Hospital Blood Purification Unit Hamamatsu Japan -

Co-author 7

Tomoyuki Fujikura tfuji@hama-med.ac.jp Hamamatsu University School of Medicine Internal Medicine 1 Hamamatsu Japan -

Co-author 8

Naro Ohashi ohashi-n@hama-med.ac.jp Hamamatsu University School of Medicine Postgraduate Clinical Education Center Hamamatsu Japan -

Co-author 9

Hideo Yasuda ysdh@hama-med.ac.jp Hamamatsu University School of Medicine Internal Medicine 1 Hamamatsu Japan -

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

In critically ill patients, hypophosphatemia has been reported to prolong intensive care unit (ICU) stay and duration of mechanical ventilation. However, there have been no reports focusing exclusively on maintenance hemodialysis (HD) patients. Moreover, the influence of hypophosphatemia on changes in ambulatory function during hospitalization remains unclear. We therefore investigated these effects in maintenance HD patients admitted to the ICU.

Methods

We retrospectively observed 56 maintenance HD patients (36 men, mean age 70.3 ± 9.7 years) who were admitted to our ICU. Patients were divided into two groups: those who developed hypophosphatemia, defined as serum phosphorus <2.5 mg/dL for ≥3 consecutive days, and those who did not. We compared ICU stay, duration of mechanical ventilation, total hospital stay, and changes in ambulatory independence from admission to discharge between the two groups.

Results

Hypophosphatemia occurred in 39% of patients. Compared with patients without hypophosphatemia, those who developed hypophosphatemia had significantly longer ICU stay, duration of mechanical ventilation, and hospital stay. Hypophosphatemia correlated with these outcomes independently of the duration of continuous hemodiafiltration (CHDF). Ambulatory independence decreased during hospitalization in both groups, with no significant difference between them.

Conclusion

Among maintenance HD patients admitted to the ICU, the development of hypophosphatemia was associated with prolonged ICU stay, longer mechanical ventilation, and extended hospitalization. These findings suggest that hypophosphatemia may contribute to poorer clinical courses in critically ill HD patients.

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