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Dialysis fluid temperature and vasoactive substances during routine hemodialysis
J Hegbrant1, L Mãrtensson, R Ekman
1Department of Nephrology, University Hospital Lund, Sweden.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 1, 1994
Summary
Cold hemodialysis (HD) improves blood pressure stability compared to warm HD. This study found no significant differences in vasoactive peptides or sympathetic drive between the two methods, despite improved stability with cold HD.
Area of Science:
- Nephrology
- Cardiovascular Physiology
Background:
- Hemodialysis (HD) can cause blood pressure fluctuations.
- Cold HD is anecdotally associated with better blood pressure stability than warm HD.
Purpose of the Study:
- To investigate the effect of dialysate temperature on blood pressure stability during hemodialysis.
- To examine the impact of cold versus warm HD on vasoactive peptides, noradrenaline (NA), and plasma renin activity (PRA).
Main Methods:
- Ten hemodynamically stable patients underwent 240-minute HD sessions at two dialysate temperatures: 38.5°C (warm HD) and 34.5°C (cold HD).
- Plasma levels of vasoactive peptides, NA, and PRA were measured.
- Blood pressure and vasodilator responses were monitored.
Main Results:
- Blood pressure decreased during warm HD but remained stable during cold HD.
- No significant differences were observed in vasoconstrictor levels between warm and cold HD.
- While NA decreased and PRA tended to increase, arginine vasopressin remained unchanged. Neuropeptide Y (NPY) showed a small increase during cold HD but not significantly different from warm HD.
- Vasoactive peptide levels and vasodilator responses did not differ significantly between the two HD temperatures.
Conclusions:
- Cold HD provides better blood pressure stability compared to warm HD.
- This improved stability is not explained by differences in plasma levels of vasoactive peptides or sympathetic drive.