{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:59:54Z","timestamp":1785214794829,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015699","name":"Fresenius Medical Care","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015699","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Effective fluid management is critical for improving outcomes in patients undergoing chronic hemodialysis (HD). Relative blood volume monitoring (RBVM) supports the optimization of ultrafiltration rate adjustments; however, real-world evidence evaluating its impact on hospitalizations in chronic HD is limited. Methods: We conducted a retrospective, propensity score\u2013matched observational cohort study comparing patient outcomes across 165 Fresenius Kidney Care clinics with high RBVM utilization (HI-RBVM; &gt;90% of treatments) matched to 165 clinics not using RBVM (NO-RBVM). Data were collected from July to December 2022. Primary outcomes were patient-level all-cause and fluid-related hospitalizations and hospitalization days over a 6-month follow-up. Multivariable scaled Poisson regression models were used to estimate adjusted incidence rates, rate ratios, and rate differences. Secondary outcomes included patient-level changes in monthly clinical measurements. Results: 24,958 patients were included (11,840 across HI-RBVM clinics; 13,118 across NO-RBVM clinics). Adjusted incidence rates were lower in the HI-RBVM group compared to the NO-RBVM group for all-cause hospitalizations (1.57 vs. 1.70 per person-year [ppy]), fluid-related hospitalizations (0.30 vs. 0.35 ppy), and hospitalization days (9.60 vs. 10.8 ppy), corresponding to 119 fewer hospital days per 100 patient-years (95% CI: \u2013184, \u221254; p &lt; 0.001). Among patients with dialysis vintage \u22646 months, those treated in HI-RBVM clinics had smaller increases in pre-HD weight (\u20130.03 kg vs. +0.46 kg; p = 0.008) and ultrafiltration volume (0.11 L vs. 0.21 L; p = 0.004), and underwent more frequent estimated dry weight (EDW) adjustments (mean 7.73 vs. 6.61; p &lt; 0.001). Conclusions: Among HD patients, high RBVM utilization at the clinic level was associated with lower rates of hospitalization. Prospective or quasi-experimental studies are needed to determine causality.<\/jats:p>","DOI":"10.3390\/jcm15155821","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:47:41Z","timestamp":1785145661000},"page":"5821","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lower Hospitalization Rates During Fluid Management with Relative Blood Volume Monitoring: A Retrospective Cohort Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Linda H.","family":"Ficociello","sequence":"first","affiliation":[{"name":"Renal Research Institute, 920 Winter St, Waltham, MA 02451, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijiao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Renal Research Institute, 920 Winter St, Waltham, MA 02451, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mianli","family":"Xiao","sequence":"additional","affiliation":[{"name":"Renal Research Institute, 920 Winter St, Waltham, MA 02451, USA"},{"name":"College of Public Health, University of South Florida, Tampa, FL 33612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Han","sequence":"additional","affiliation":[{"name":"Renal Research Institute, 920 Winter St, Waltham, MA 02451, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-4544","authenticated-orcid":false,"given":"Michael S.","family":"Anger","sequence":"additional","affiliation":[{"name":"Fresenius Medical Care, Waltham, MA 02451, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Hymes","sequence":"additional","affiliation":[{"name":"Fresenius Medical Care, Waltham, MA 02451, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6406-093X","authenticated-orcid":false,"given":"Dinesh","family":"Chatoth","sequence":"additional","affiliation":[{"name":"Fresenius Medical Care, Waltham, MA 02451, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","unstructured":"United States Renal Data System (2024). 2024 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1053\/j.ajkd.2014.07.003","article-title":"Improving Clinical Outcomes Among Hemodialysis Patients: A Proposal for a \u201cVolume First\u201d Approach from the Chief Medical Officers of US Dialysis Providers","volume":"64","author":"Weiner","year":"2014","journal-title":"Am. 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