Effect of variations in dialysate temperature on blood pressure during hemodialysis

The effect on BP of alteration in dialysate temperature was studied in 150 hemodialysis treatments in 17 patients using a randomized, double-blind protocol. Each patient was treated using dialysate at 35.6 degrees C, 36.7 degrees C, and 37.8 degrees C. Mean BP during 35.6 degrees C dialysis was significantly higher than during 36.7 degrees C or 37.8 degrees C treatments. Symptomatic hypotensive episodes were more frequent at a dialysate temperature of 37.8 degrees C than during use of cooler dialysates. Modest changes in dialysate temperature thus appear to affect BP during hemodialysis. Dialysate cooler than that routinely employed has a beneficial effect while warmer dialysate has a detrimental one on intradialytic BP. The use of dialysate at least 1 degree C cooler than "isothermic" levels may be appropriate.