Hemodialysis with low-temperature dialysate: a long-term experience

Area of Science:

• Nephrology
• Cardiovascular Physiology
• Dialysis Technology

Background:

• Hemodialysis (HD) can induce symptomatic hypotension (SH), particularly in patients with high incidence.
• Dialysate temperature is a modifiable factor that may influence HD-induced symptoms.

Purpose of the Study:

• To investigate the effect of cool dialysate (35°C) compared to standard temperature (37°C) on hemodialysis-induced symptoms.
• To assess the impact of dialysate temperature on hypotension, blood pressure, weight loss, and overall symptom experience.

Main Methods:

• A study involving 8 non-diabetic, non-anephric patients with a history of SH.
• Patients underwent two 6-month periods: one with 37°C dialysate and another with 35°C dialysate.
• Data collected included incidence of SH, weight loss, predialysis systolic blood pressure (SBP), and specific symptoms like cramps.

Main Results:

• Cooler dialysate (35°C) significantly decreased SH (47.4% vs. 33.9%) and improved overall symptoms (55.6% vs. 45.8%).
• Patients experienced greater weight loss (1.52 vs. 1.71 kg) and stabilized SBP at a lower level (144 vs. 139 mm Hg) with cool dialysate.
• Cramps increased significantly at 35°C (2.7% vs. 10.9%), associated with greater weight loss, but 7 out of 8 patients reported overall symptom amelioration.

Conclusions:

• Using cool dialysate (35°C) during hemodialysis is effective in reducing symptomatic hypotension and improving patient comfort.
• Despite an increase in cramps, cooler dialysate offers a net benefit for most patients undergoing hemodialysis.
• Dialysate temperature is a crucial factor in managing hemodialysis-induced symptoms and optimizing patient tolerance.