Yu AW, Ing TS, Zabaneh RI, Daugirdas JT
Effect of dialysate temperature on central hemodynamics
and urea kinetics
(Jul) 48:237-243 1995
Use of cool dialysate is associated with higher intradialytic
blood pressure, but the hemodynamic mechanism of this was unclear.
Also, there was some concern that if cool dialysate use limits blood
flow to muscle, urea sequestration might be increased and urea removal
might be impaired. Cardiac output was measured using bioimpedance. In
nine patients, each studied multiple times, increased BP during cool
dialysate use was found to be due to higher total peripheral
resistance. Cardiac output was similar to that using warm dialysate.
Use of cool dialysate had no effect on urea sequestration or removal.
The authors theorize that muscle blood flow probably is not much
affected by cool dialysate use, which may increase vascular resistance
primarily by constricting blood vessels leading to the skin. Also,
slight shivering may help maintain and even increase muscle blood flow.
The clinical implication is that cool dialysate can be used without
fear of impairing urea removal.
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