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Heat accumulation with relative blood volume decrease.

Daniel Schneditz1, Laura Rosales, Allen M Kaufman

  • 1Renal Research Institute; and the Division of Nephrology, Beth Israel Medical Center, New York, NY, USA. daniel.schneditz@uni-graz.at

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|September 27, 2002
PubMed
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Hypovolemia and heat accumulation during hemodialysis are linked. As blood volume decreases due to ultrafiltration, heat accumulation increases, highlighting the importance of temperature control in dialysis.

Area of Science:

  • Nephrology
  • Physiology
  • Biomedical Engineering

Background:

  • Hypovolemia and heat accumulation significantly impact blood pressure control.
  • These perturbations often occur concurrently during hemodialysis treatments.
  • Understanding the relationship between hypovolemia and heat accumulation is crucial for patient safety.

Purpose of the Study:

  • To investigate the link between hypovolemia and heat accumulation during hemodialysis.
  • To quantify the extent to which ultrafiltration-induced hypovolemia contributes to heat stress.

Main Methods:

  • Measured heat accumulation (thermal energy, E) using isothermic hemodialysis and a blood temperature monitor.
  • Monitored relative blood volume (RBV) using a blood volume monitor.
  • Analyzed data from 38 treatments in 12 patients.

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Main Results:

  • Ultrafiltration led to a decrease in blood volume (to 85% +/- 7% of initial values) and heat removal (229 +/- 106 kJ).
  • Heat accumulation (E, cooling rate J) significantly increased as RBV decreased (P < 0.05).
  • A strong correlation was found between cooling rate and RBV (J = -102.38 + 0.97* RBV; r2 = 0.63).

Conclusions:

  • The risk of heat stress during hemodialysis escalates with greater ultrafiltration-induced blood volume reduction.
  • Effective temperature management is a critical component of hemodialysis therapy.