Fine A, Janzen L, Penner B
The protective effect of cool dialysate is dependent on
patients' predialysis body temperature
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:599 1995
The benefits of cool dialysate (35 degrees C) are well known,
although some patients do not appear to benefit. In this study
28/128 HD patients were found to have a mean baseline body temp
less than 36 degrees C. Such hypothermic patients had less symptomatic
hypotension with cool dialysate than with 37 degree C dialysate. However, in
48/128 patients
predialysis body temp was greater than 36.5 degrees C. In these
patients cool dialysate use was not associated with decreased
symptomatic hypotensive episodes. The idea is, that if you're hypothermic to
begin with, use of 37 degree C dialysate may warm you up, causing
vasodilatation and occasionally, hypotension. If your
body temperature is close to 37 degrees C to begin with, use of 37 degrees C
dialysate will not cause much of a warming effect, and there will be no
adverse hemodynamic effects. In such patients, there is little benefit to be
gained from going to a cool dialysate, and, in fact, such patients might be
more prone to shivering and feeling cold
when cool dialysate is used.
(Daugirdas)
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Am Soc Nephrol
Basic hemodialysis :
Complications (acute)