{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:20:04Z","timestamp":1773465604075,"version":"3.50.1"},"reference-count":10,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: Patients receiving in-center hemodialysis are at a high risk of coronavirus disease 2019 (COVID-19) infection. A reduction in hemodialysis frequency is one of the proposed measures for preventing COVID-19 infection. However, the predictors for determining an unsuccessful reduction in hemodialysis frequency are still lacking. Materials and Methods: This retrospective observational study enrolled patients who were receiving long-term thrice-weekly hemodialysis at the Thammasat University Hospital in 2021 and who decreased their dialysis frequency to twice weekly during the COVID-19 outbreak. The outcomes were to determine the predictors and a prediction model of unsuccessful reduction in dialysis frequency at 4 weeks. Bootstrapping was performed for the purposes of internal validation. Results: Of the 161 patients, 83 patients achieved a dialysis frequency reduction. Further, 33% and 82% of the patients failed to reduce their dialysis frequency at 4 and 8 weeks, respectively. The predictors for unsuccessful reduction were diabetes, congestive heart failure (CHF), pre-dialysis overhydration, set dry weight (DW), DW from bioelectrical impedance analysis, and the mean pre- and post-dialysis body weight. The final model including these predictors demonstrated an AUROC of 0.763 (95% CI 0.654\u20130.866) for the prediction of an unsuccessful reduction. Conclusions: The prediction score involving diabetes, CHF, pre-dialysis overhydration, DW difference, and net ultrafiltration demonstrated a good performance in predicting an unsuccessful reduction in hemodialysis frequency at 4 weeks.<\/jats:p>","DOI":"10.3390\/jcm12072550","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T06:15:15Z","timestamp":1679984115000},"page":"2550","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors for Unsuccessful Reductions in Hemodialysis Frequency during the Pandemic"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2028-5037","authenticated-orcid":false,"given":"Suthiya","family":"Anumas","sequence":"first","affiliation":[{"name":"Chulabhorn International College of Medicine, Thammasat University, Pathum Thani 12120, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sithichai","family":"Kunawathanakul","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pichaya","family":"Tantiyavarong","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand"},{"name":"Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2888-881X","authenticated-orcid":false,"given":"Pajaree","family":"Krisanapan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6010-0033","authenticated-orcid":false,"given":"Pattharawin","family":"Pattharanitima","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2023, February 28). Coronavirus Disease 2019 (COVID-19) Situation Report\u201452. Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/situation-reports\/20200312-sitrep-52-covid-19.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Dessie, Z.G., and Zewotir, T. (2021). Mortality-Related Risk Factors of COVID-19: A Systematic Review and Meta-Analysis of 42 Studies and 423,117 Patients. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06536-3"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ghonimi, T.A.L., Alkad, M.M., Abuhelaiqa, E.A., Othman, M.M., Elgaali, M.A., Ibrahim, R.A.M., Joseph, S.M., Al-Malki, H.A., and Hamad, A.I. (2021). Mortality and Associated Risk Factors of COVID-19 Infection in Dialysis Patients in Qatar: A Nationwide Cohort Study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254246"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s40620-021-01206-8","article-title":"COVID-19 and Chronic Kidney Disease: An Updated Overview of Reviews","volume":"35","author":"Jdiaa","year":"2022","journal-title":"J. Nephrol."},{"key":"ref_5","unstructured":"(2023, February 26). Coronavirus Disease (COVID-19): How Is It Transmitted?. Available online: https:\/\/www.who.int\/news-room\/questions-and-answers\/item\/coronavirus-disease-covid-19-how-is-it-transmitted."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1681\/ASN.2020030361","article-title":"Twice-Weekly Hemodialysis Is an Option for Many Patients in Times of Dialysis Unit Stress","volume":"31","author":"Meyer","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1053\/j.ajkd.2015.07.015","article-title":"KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update","volume":"66","author":"Daugirdas","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.kint.2020.04.007","article-title":"Managing the COVID-19 Pandemic: International Comparisons in Dialysis Patients","volume":"98","author":"Kliger","year":"2020","journal-title":"Kidney Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1177\/1536867X211025836","article-title":"Bootstrap Internal Validation Command for Predictive Logistic Regression Models","volume":"21","author":"Muriel","year":"2021","journal-title":"Stata J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lodge, M.D.S., Abeygunaratne, T., Alderson, H., Ali, I., Brown, N., Chrysochou, C., Donne, R., Erekosima, I., Evans, P., and Flanagan, E. (2020). Safely Reducing Haemodialysis Frequency during the COVID-19 Pandemic. BMC Nephrol., 21.","DOI":"10.1186\/s12882-020-02172-2"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2550\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:04:59Z","timestamp":1760123099000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,28]]},"references-count":10,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12072550"],"URL":"https:\/\/doi.org\/10.3390\/jcm12072550","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,28]]}}}