IDH remains a significant clinical problem. Recent evidence from the last 2 years does not support any major changes to current practice, with cooling of the dialysate and reduction of IDWG remaining cornerstones of management.

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Introduction: Renal replacement therapy (RRT) patients are known to have large number of comorbidities and hence, have high hospitalisation rates. The primary aim of the present study was to compare rates of hospitalisation in year one of incident dialysis patients treated with peritoneal dialysis (PD) or with haemodialysis (HD). Methods: We performed retrospective review of all the patients who commenced RRT during April 2013 to March 2016. We collected demographic data, date of commencement of RRT, starting modality, first contact date with renal services, type of access, Charlson's comorbidity score (CCS) and the details regarding hospital admission within the first year of starting RRT including data about switching modality from electronic patient records. Data was analysed using SPSS V24. Results: 200 patients commenced RRT over 3 year from April 2013-March 2016. Median age of starting RRT was 61.7 years (IQR: 21), 66% (n¼132) were males and majority were whites (83.5%). Median CCS was 5 (IQR: 3) and 41.5% were diabetics. 107 patients commenced RRT on HD and rest of 93 on PD.During the one-year follow up period after starting RRT, there were 434 admissions in 130 (65%) patients. 70 (65.4%) of 107 HD and 60 (64.5%) of 93 PD patients were admitted atleast once during the first year of RRT. Median number of admissions were 2.5 (IQR: 3) and cumulative in-patient days in 1 year were 12 (IQR: 27).On comparison of patients groups by starting modality, HD patients were older (65 years; IQR 23 years) as compared to PD patients (58.7 years; IQR 16 years) (P¼0.003). There were 236 admissions in HD group and 198 in PD group, however there were more admissions related to medical issues (32% in HD vs 19 % in PD) in HD group vs more admissions related to dialysis issues (9% in HD vs 13% in PD) in PD group. CCS was higher in HD at 6 (IQR 3) as compared to PD patients which was 5 (IQR 3) (P¼ 0.017). Median number of admission HD vs PD were 2 (IQR: 2) vs 3 (IQR: 3) (P ¼ 0.801) and cumulative days of admission in HD vs PD were 13 (IQR: 27) vs 10.5 (IQR: 23) (P¼0.504). Conclusions: Burden of hospitalisation is high in renal replacement therapy population. Even though there was significant difference in the age and comorbidity index of the patients in both admitted HD and PD groups, there was no difference in the number of admission and the hospital days between groups. Further work is required to explore factors contributing the above.

Twelve patients underwent serial cardiac, cerebral and renal multiparametric 3T MRI scans before, during and after haemodialysis. During dialysis, there was a significant decline in cardiac and stroke index and myocardial strain, with increased diastolic dysfunction. This was accompanied by a reduction in blood flow to both the heart and brain. White matter T1 increased during dialysis suggesting fluid shifts increasing water content resulting in local oedema. Total kidney volume, renal cortex T1 and T2* all reduced during dialysis likely reflecting reduced renal blood volume and change in renal tissue water. These results highlight the acute multi-organ effects of dialysis.