Reducing Dialysate Temperature and Hemodynamic Stability among Hemodialysis Patients who were Susceptible to Hemodynamic Instability- a Cross Over Study

Hemodynamic instability is the most common acute complication of hemodialysis. Lowering the dialysate temperature has been proposed to prevent this event. The efficacy of this method for all patients is under question. Therefore in this study the effect of cool dialysis on patients who underwent hemodialysis and who were susceptible to hemodynamic instability was investigated. Subjects and

Thirty-one patients who were hypotension-prone during hemodialysis were enrolled in this cross-over study. Each patient was hemodialyzed twice, once using cool and once using standard temperature dialysate solution. The wash-out period was one week. Except temperature, other condition were maintained all the same. Systolic blood pressure(SBP), diastolic blood pressure (DBP), heart rate (HR) and mean arterial pressure (MAP) were measured hourly and their changes from baseline values were calculated. Oral temperature and the number of hypotensive episodes were recorded. SPSS 17 was used for data analysis.

SBP changes (in 2nd and 3rd hours), DBP changes (in 3rd hour) and MAP changes (in 2nd, 3rd hours) were significant with following P<0.01, 0.01, 0.01, <0.01, 0.001 respectively. Percentage of hypotensive episodes during standard and cool dialysis were 57.1 and 7.1 respectively (P=0.013).

It seems cool hemodialysis can reduce hemodynamic instability during hemodialysis especially in patients who are susceptible to this complication.