The Effects of Cool Dialysate on Vital Signs, Adequacy and Complications during Hemodialysis
Abstract
Background: Cooling the dialysate is an important factor that contributes to the hemodynamic stability in patients during hemodialysis. The aim of this study was to determine the effect of cool dialysate on vital signs, and the adequacy and common complications of hemodialysis.
Materials and Methods: The present crossover, triple‑blind, clinical trial was performed on 62 dialysis patients, who were selected through stratified block randomization. First, one group underwent hemodialysis using a cool dialysate (35°C), and the other received routine hemodialysis (36.5°C). Each patient received a total of eight hemodialysis sessions. Then, treatment methods were swapped, and each group received the other group’s method. The patients’ blood pressure, pulse rate, and temperature were measured before dialysis, and in the first, second, third, and fourth hours of dialysis. The frequency of common complications of hemodialysis and dialysis efficacy were measured. The marginal model and Generalized Estimating Equations (GEE) were used to analyze the data.
Results: The participants’ systolic (p = 0.01) and diastolic blood pressures significantly increased with a decrease in temperature (p = 0.005). The patients’ pulse rate (p = 0.143), adequacy of dialysis (p = 0.922), and common complications of hemodialysis did not significantly differ between the two temperatures (p > 0.05).
Conclusions: Reducing dialysate temperature from 36.5 to 35°C led to hemodynamic stability; the blood pressure of the patients undergoing hemodialysis was more stable with the cool dialysate method and the number of drops in the blood pressure during the hemodialysis was reduced.
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Mohammadi Kalaveh S, Toulabi T, Hasanvand S, Gholami M, Ghasemi F. The impact of multidisciplinary rehabilitation on depressive symptoms in hemodialysis patients. West J Nurs Res 2018;40:738 52.
Jafari H, BagheriNesami M, Esmaeili R, Goudarzian AH, Mohammadi F. Prevalence of adverse effects of hemodialysis in patients dialyzing in Fatemeh Zahra Teaching Hospital, 2014. Tabari J Prevent Med 2015;1:46 52.
Sajadi M, Gholami Z, Hekmatpour D, Soltani P, Haghverdi F. Cold dialysis solution for hemodialysis patients with fatigue. Iran J Kidney Dis 2016;10:319 24.
Tayyebi I, Savari S, Nehrir B, Rahimi A, Eynollahi B. The effect of Vitamin B12 supplementation on fatigue in hemodialysis patients. IJCCN 2013;6:39 48.
Borzou S, Farmani A, Salvati M, Gholyaf M, Mahjoub H. The impact of linear sodium ultrafiltration profiling on hemodialysis tolerance. Mod Care J 2014;11:283 92.
Hamidi M, Roshangar F, Ghafourifard M, Hassankhani H, Sarbakhsh P. A comparative study of the prevalence rate of common complications in routine hemodialysis, and linear and stepwise sodium ultra filtration profile in patients with chronic kidney failure under hemodialysis. Nurs Midwifery J 2019;17:444 52.
Toulabi T, Kalaveh SM, Ghasemi F, Anbari K. The impact of multidisciplinary rehabilitation on the quality of life of hemodialysis patients in Iran. J Formos Med Assoc 2016;115:553 9.
Selby NM, McIntyre CW. A systematic review of the clinical effects of reducing dialysate fluid temperature. Nephrol Dial Transplant 2006;21:1883 98.
Shahgholian N, Ghafourifard M, Shafiei F. The effect of sodium and ultra filtration profile combination and cold dialysate on hypotension during hemodialysis and its symptoms. Iran J Nurs Midwifery Res 2011;16:212 16.
Vatandoost S, Mohammadi H, Nouri B, Mohammadi Bolbanabad A, Zamani P. Relationship between dialysis adequacy and sleep quality in hemodialysis patients. Nurs Midwifery J 2018;16:30 7.
Imani A, Karimi V, Dinmohamadi MR, Moradi F. The effect of cooled hemodialysis fluid on the adequacy of dialysis: A clinical trial. Stud Med Sci 2019;30:575 81.
Hussein TA, Malik AS. Effect of dialysate temperature on hemodynamic stability among hemodialysis patients. Iraq J Med Sci 2014;12:173 9.
Van der Sande FM, Wystrychowski G, Kooman JP, Rosales L, Raimann J, et al. Control of core temperature and blood pressure stability during hemodialysis. Clin J Am Soc Nephrol 2009;4:93 8.
Mustafa RA, Bdair F, Akl EA, Garg AX, Thiessen Philbrook H, Salameh H, et al. Effect of lowering the dialysate temperature in chronic hemodialysis: A systematic review and meta analysis. Clin J Am Soc Nephrol 2016;11:442 57.
Ayoub A, Finlayson M. Effect of cool temperature dialysate on the quality and patients perception of hemodialysis. Nephrol Dial Transplant 2003;19:190 4.
Borzou SR, Farghadani F, Oshvandi K, Gholyaf M, Mahjub H. Effect of cool dialysate on vital signs, comfort and adequacy. J Holist Nurs Midwifery 2015;25:9 16.
Dubin RF, Teerlink JR, Schiller NB, Alokozai D, Peralta CA, Johansen KL. Association of segmental wall motion abnormalities occurring during hemodialysis with post dialysis fatigue. Nephrol Dial Transplant 2013;28:2580 5.
Azar AT. Effect of dialysate temperature on hemodynamic stability among hemodialysis patient. Saudi J Kidney Dis Transpl 2009;20:596 03.
Toth Manikowski SM, Sozio SM. Cooling dialysate during in center hemodialysis: Beneficial and deleterious effects. World J Nephrol 2016;5:166–71.
Sakkas GK, Krase AA, Giannaki CD, Karatzaferi C. Cold dialysis and its impact on renal patients’ health: An evidence based mini review. World J Nephrol 2017;6:119 22.
Hatef M, Mousavinasab N, Esmaeili R, Kamali M, Madani Z, Spahbodi F, et al. The effects of exercise training on physical performance and self effcacy in hemodialysis patients: A randomized controlled clinical trial. Iran J Nurs Midwifery Res 2020;25:520 6.
Liang KV, Zhang JH, Palevsky PM. Urea reduction ratio may be a simpler approach for measurement of adequacy of intermittent hemodialysis in acute kidney injury. BMC Nephrol 2019;20:1272 7.
Moujerloo M, Molaie E, Montazer Z, Behnampour N, Shariati A, Khari M. Effect of cool dialysate on hypotention and some interventions during dialysis. J Res Dev Nurs Midw 2015;12:56 63.
Teruel JL, Martins J, Merino L, Fernández Lucas M, Rivera M, Marcén R, et al. Temperature of the dialysis bath and hemodialysis tolerance. Nefrología 2006;26:461 8.
Ghasemi A, Shafiee M, Rowghani K. Stabilizing effects of cool dialysate temperature on hemodynamic parameters in diabetic patients undergoing hemodialysis. Saudi J Kidney Dis Transpl 2008;19:378 83.
Stefánsson BV, Brunelli SM, Cabrera C, Rosenbaum D, Anum E,Ramakrishnan K, et al. Intradialytic hypotension and risk of cardiovascular disease. Clin J Am Soc Nephrol 2014;9:2124 32.
Kashani E, Mirhosseini Z, Rastaghi S, Rad M. The effect of the cool dialysate on the restless leg syndrome in hemodialysis patients: Randomized triple blind clinical trial. Iran J Nurs Midwifery Res 2019;24:200 5.
Pérgola PE, Habiba NM, Johnson JM. Body temperature regulation during hemodialysis in long term patients: Is it time to change dialysate temperature prescription? Am J Kidney Dis 2004;44:155 65.
Usvyat LA, Raimann JG, Carter M, Van der Sande FM, Kooman JP, Kotanko P, et al. Relation between trends in body temperature and outcome in incident hemodialysis patients. Nephrol Dial Transplant 2012;27:3255 63.
Moattari M, Azarhooshang P, Abbasian A, ReisJalali G, Rajaeefard A. The effect of cool dialysate on intradialytic hypotension among end stage renal disease patients. Res Med 2007;31:67 72.
Tsujimoto Y, Tsujimoto H, Nakata Y, Kataoka Y, Kimachi M, Shimizu S, et al. Dialysate temperature reduction for intradialytic hypotension for people with chronic kidney disease requiring hemodialysis. Cochrane Database Syst Rev 2017;7:CD012598.
Larkin JW, Reviriego Mendoza MM, Usvyat LA, Kotanko P, Maddux FW. To cool, or too cool: Is reducing dialysate temperature the optimal approach to preventing intradialytic hypotension?. Semin Dial 2017;30:501 8.
Rad M, Jaghouri E, Sharifipour F, Rakhshani MH. The effects of cool dialysate on pruritus status during hemodialysis of patients with chronic renal failure: A controlled randomized clinical trial. Iran Red Crescent Med J 2016;19:e34759.
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