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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Hemodialysis initiation in end-stage renal disease is typically either planned (elective) or done on an emergency basis. Few reports investigated the length of hospitalization or discharge disposition, particularly the likelihood of discharge to home. We aimed to compare hospital length of stay and discharge outcomes between planned and emergency hemodialysis initiation.
The study design is a single-center retrospective cohort study. We identified 377 patients who initiated hemodialysis at Kobe City Medical Center General Hospital from June 2020 to December 2024. This study was approved by the hospital's ethics review committee in accordance with The Helsinki Declaration of The World Medical Association.
After excluding patients who declined participation (opted out), those discharged early for non-medical reasons (e.g., bed availability issues), and those admitted for reasons unrelated to starting dialysis, 320 patients remained for analysis. These patients were categorized into a planned initiation group (n = 138) and an emergency initiation group (n = 182). We compared outcomes between the groups, including hospital length of stay (days), discharge disposition (home vs. transfer to another facility), nutritional status assessed by the Subjective Global Assessment (SGA) score, and functional status measured by the Functional Independence Measure (FIM) score. Within the emergency initiation group, we further compared outcomes between patients who had prior outpatient nephrology follow-up and those who had no prior outpatient care. Group comparisons used chi-square tests for categorical variables and t-tests or Wilcoxon rank-sum tests for continuous variables.
Baseline characteristics were no significant differences in the proportion of male patients (63.7% vs 68.7%, p = 0.34) or in age (mean 73.4 vs 71.6 years, p = 0.07) between the planned and emergency initiation groups.
The emergency initiation group had a significantly longer hospital stay (median 21 [IQR 15–33] vs 8 [IQR 5–11]; p < 0.0001) and a significantly higher transfer rates (34.6 vs 4.3, p<0.0001) compared to the planned initiation group. The median FIM score at admission was 79.0 vs 103.3 in the planned initiation group (p < 0.0001), and the median SGA score was 5.0 vs 2.2 (p < 0.0001). By discharge, the emergency initiation group still had a significantly lower FIM score compared to the planned initiation group (median 102.2 vs 112.2; p = 0.008).
Among emergency-start patients, those without prior outpatient nephrology care experienced longer hospitalizations than those who had some outpatient follow-up before dialysis initiation (median 29 [IQR 21–40.8] vs 18 [IQR 13.8–28]; p < 0.0001). The emergency initiation group showed a numerically higher non-home discharge rate compared to the planned initiation group (45.5% vs 31.2%; p = 0.21).
The longer length of stay observed in the emergency initiation group may be explained by their poorer nutritional status and lower functional independence at admission. The emergency start patients’ lower FIM scores at discharge suggest that after hospitalization, they did not recover full independence and required ongoing rehabilitation.
Beginning hemodialysis in an unplanned emergency setting is associated with prolonged hospital stays and a reduced likelihood of discharge to home.
