# Patient Symptoms on Hemodialysis-Timing, Variability and Causes

> **NIH NIH R03** · BRIGHAM AND WOMEN'S HOSPITAL · 2020 · $89,500

## Abstract

PROJECT SUMMARY
There are over 400,000 patients in the United States that are dependent on the life-preserving benefits of
maintenance hemodialysis (HD). However, debilitating physical symptoms are estimated to affect over 50% of
patients during the HD procedure, often resulting in reduced quality of life. Despite decades of experience, the
exact timing, session-to-session variability, and potential etiologies of such symptoms remain unclear. Our
prior work has suggested that rapid rates of decline in plasma osmolality may play an important role in both
blood pressure decline and symptoms (such as chest pain and headache) early in the course of HD sessions;
while others suggest that inaccurate volume assessment and higher rates of ultrafiltration may play a role later
in the HD session. To address these gaps in knowledge, in Aim 1, we propose a detailed analysis of the
timing, frequency and variability of patient symptoms in a prospective cohort of contemporary HD patients. In
Aim 2, we will leverage innovative point-of-care methods to aid in the assessment of volume status, and
determine the association of osmolality decline, ultrafiltration rate and objective volume metrics (lung
ultrasound and inferior vena cava diameter) with patient symptoms during HD. In summary, our proposals are
clinically relevant, feasible and innovative. Moreover, they will provide important preliminary data that is highly
relevant to future interventional studies and R01 applications. Building on the underlying pathophysiology and
our experience in performance of clinical trials, our proposals have the potential to improve care for patients
undergoing maintenance HD for kidney failure.

## Key facts

- **NIH application ID:** 9934193
- **Project number:** 5R03DK122240-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Finnian R McCausland
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $89,500
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9934193

## Citation

> US National Institutes of Health, RePORTER application 9934193, Patient Symptoms on Hemodialysis-Timing, Variability and Causes (5R03DK122240-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9934193. Licensed CC0.

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