The Effect of Reduced Dialysate Temperature on Dialysis Adequacy of Diabetic Patients (A Clinical Trial Study)

Given that diabetes is the most prevalent cause of end-stage renal disease (ESRD) and that dialysis adequacy is an important factor in the survival of diabetic patients, prognosis of these individuals is predicated according to adequate and standard hemodialysis. The present study aimed at investigating the effect of lowering dialysate solution temperature on dialysis adequacy. This was a clinical trial, in which 32 qualified patients were studied. The subjects were chosen by convenience sampling from patients, who had referred to Ali-Ibn Abitaleb Hospital of Zahedan in spring, 2018. Each patient underwent hemodialysis twice, in which the solution temperature was reduced by one temperature from 37°C to 36°C. Except for the temperature decrease, other conditions were identical during the study. To evaluate the adequacy of dialysis in each session, blood samples of patients were examined before and after dialysis. Data were analyzed in SPSS 21 using descriptive statistics and dependent t-test. The significance level was set below 0.05. The mean and standard deviation of age was equal to 60.2 ± 9.2 (year), duration of diabetes was 12.07 ± 7.25 years, duration of hemodialysis was 27.7 ± 21.8 (months), and weight gain between two sessions of dialysis was 1.6 ± 0.68 (kg). The mean and standard deviation of dialysis adequacy index equaled 1.14 ± 0.34 in the two cold sessions and 0.98 ± 0.20 in the routine session, suggesting significantly higher value in the cold sessions (P < 0.001). Administering cold dialysis solution (36°C) positively influences dialysis adequacy. Therefore, if patients are not medically prohibited from using the cold solution, cold dialysis solution should be prescribed to hemodialysis patients.