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Published on: October 2, 2020

Association between cold dialysis and cardiovascular survival in hemodialysis patients

Heng-Jung Hsu1, Chiung-Hui Yen, Kuang-Hung Hsu

  • 1Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|November 8, 2011
PubMed

Insights

Cold dialysis (CD) significantly reduces overall and cardiac mortality in hemodialysis patients. This study found CD independently associated with better long-term survival, highlighting its potential clinical benefits.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Trials

Background:

  • Patients with chronic kidney disease (CKD) exhibit elevated cardiovascular mortality.
  • The impact of impaired energy expenditure in CKD on cardiovascular disease remains under investigation.
  • The clinical outcomes associated with cold dialysis (CD) in hemodialysis patients are not well-established.

Purpose of the Study:

  • To investigate the association between cold dialysis (CD) and clinical outcomes, specifically mortality, in hemodialysis patients.
  • To determine if CD influences overall, cardiac, and non-cardiac mortality rates.
  • To evaluate the long-term survival benefits of CD compared to standard dialysis (SD).

Main Methods:

  • A single-center retrospective cohort study comparing a CD group (dialysate temperature <35.5 °C) with a standard dialysis (SD) group (dialysate temperature 35.5–37 °C).
  • Analysis of overall mortality, cardiac mortality, and non-cardiac mortality as study endpoints.
  • Propensity score analysis was employed to adjust for baseline differences between the CD and SD groups.

Main Results:

  • Kaplan-Meier analysis revealed that CD was significantly linked to a reduced risk of overall mortality (P = 0.006) and cardiac mortality (P = 0.023).
  • Multivariate Cox regression, including propensity score adjustment, confirmed CD as a significant protective factor for overall mortality (P = 0.030) and cardiac mortality (P = 0.034).
  • No significant association was found between CD and non-cardiac or infectious mortality.

Conclusions:

  • Cold dialysis (CD) demonstrates a significant and independent association with decreased overall mortality in hemodialysis patients.
  • CD is independently linked to a lower risk of cardiac mortality, suggesting a cardioprotective effect.
  • The findings support CD as a potentially beneficial intervention for improving survival outcomes in hemodialysis patients.
Abstract

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