Effect of dialysate temperature on peritoneal clearances

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Technology

Background:

• Peritoneal dialysis (PD) is a crucial renal replacement therapy for uremic patients.
• Dialysate temperature is a variable that may influence PD efficiency.
• Warming dialysate to body temperature (37°C) is a common practice, but its necessity in warmer climates is debated.

Purpose of the Study:

• To investigate the impact of dialysate temperature on the efficiency of peritoneal dialysis in uremic patients.
• To compare urea, creatinine, and inulin clearance between room temperature and prewarmed dialysate.
• To assess the effect of dialysate temperature on ultrafiltration and protein loss during PD.

Main Methods:

• A comparative study involving 18 uremic patients undergoing peritoneal dialysis.
• Dialysis was performed using both room temperature (27-31°C) and prewarmed (37°C) dialysate in separate periods.
• Key parameters including solute clearance, drainage volume, ultrafiltration rate, and protein loss were measured and compared.

Main Results:

• No significant differences were observed in urea, creatinine, or inulin clearance between room temperature and prewarmed dialysate periods.
• Ratios of solute clearances (inulin/urea, inulin/creatinine) remained statistically similar.
• Drainage volume, dialysate flow rate, ultrafiltration rate, and total protein loss showed no significant variation with dialysate temperature.

Conclusions:

• Warming dialysate to 37°C does not enhance peritoneal dialysis efficiency in the studied temperature range (27-31°C).
• The warming procedure for dialysate may be omitted in regions with average room temperatures around 29°C (27-31°C).
• Eliminating the dialysate warming step can reduce workload and minimize the risk of dialysate contamination, improving PD practice.