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152625

Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists

Article

Last updated: 04 Jan 2025

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Subjects

-

Tags

Internal Medicine

Abstract

Background: Intra-dialytic hypotension (IDH) and pruritus are frequent and distressing complications during hemodialysis; moreover, they are associated with adverse outcomes.   
The aim of the work: The current work aimed to investigate the effect of applying individualized cool dialysate (ICD) on IDH, dialysis adequacy, pruritus and its acceptance by both patient and nephrologists.
Patients and Methods: This is a non-randomized single center study that was conducted at Al-Azher nephrology and dialysis unit. The study was carried out over a period of fvie weeks. Core body temperature (CBT) and dialysis adequacy (by Kt/v) were measured. Patients who fulfilled the inclusion and exclusion criteria underwent hemodialysis for six consecutive sessions at dialysate temperature of 37°C, followed by another six consecutive sessions at ICD temperature (0.5 oC below CBT). Blood pressure (BP) measurements, episodes of hypotension, pruritus score, patients and nephrologist questionnaire were collected during both standard and cool phases.
Results: The study included 50 patients, the mean age 51.10±11.57 years, and males constituted 64% . The implementation of ICD has been associated with a significant reduction in IDH episodes (p <0.001). The lowest intra-dialytic and post-dialytic BP measurements were statistically higher during cool phase. There was a significant reduction in pruritus VAS score during cool phase (p <0.001), whereas Kt/v and ultrafiltration rate did not statistically differ between both phases. ICD was well tolerated by patients; although 60% of them experienced cold sensation that warranted no intervention. Nephrologists (n=20) trusted in cool dialysate as an effective intervention for IDH management. However, a proportion of them (60%) had a concern about patient tolerability.
Conclusion: ICD is a well-tolerated intervention that is universally applied without additional cost. It improves hemodynamic instability and pruritus during hemodialysis treatment without negative impact on dialysis adequacy. It is accepted by nephrologists as an effective tool in stabilizing hemodynamic instability during dialysis treatment.

DOI

10.21608/ijma.2021.50763.1244

Keywords

cool, Hemodialysis, hypotension, pruritus, adequacy

Authors

First Name

Mona

Last Name

Elsayyad

MiddleName

Ahmad

Affiliation

Department of Internal Medicine, Damietta Specialized Hospital, Minsitry of Health, Egypt

Email

hoorein76@yahoo.com

City

Damietta

Orcid

0000-0002-0140-677X

First Name

Mostafa

Last Name

Abdelsalam

MiddleName

-

Affiliation

Department of Internal Medicine, Mansoura Nephrology and Dialysis Unit, Faculty of Medicine, Mansoura University, Egypt

Email

darsh1980@mans.edu.eg

City

Mansoura

Orcid

0000-0002-4682-2777

First Name

Osama

Last Name

Ahmad

MiddleName

Mohamad

Affiliation

Department of Internal Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

osama31166@gmail.com

City

Damietta

Orcid

0000-0002-3434-1685

First Name

Ehab

Last Name

Eltoraby

MiddleName

-

Affiliation

Department of Internal Medicine, Rheumatology and Immunology Unit, Faculty of Medicine, Mansoura University, Egypt

Email

ehabeltoraby@yahoo.com

City

Mansoura

Orcid

0000-0003-4183-7475

First Name

Mona

Last Name

Tawfik

MiddleName

-

Affiliation

Department of Internal Medicine, Mansoura Nephrology and Dialysis Unit, Faculty of Medicine, Mansoura University, Egypt

Email

monatawfic@mans.edu.eg

City

Mansoura

Orcid

0000-0002-0345-779X

Volume

3

Article Issue

2

Related Issue

24821

Issue Date

2021-04-01

Receive Date

2021-01-14

Publish Date

2021-04-01

Page Start

1,257

Page End

1,265

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 2_Pages 1257-1265.pdf

PDF . 1.3MB

Link

https://ijma.journals.ekb.eg/article_152625.html

Detail API

https://ijma.journals.ekb.eg/service?article_code=152625

Order

13

Type

Original Article

Type Code

816

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

MainTitle

Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists

Details

Type

Article

Created At

22 Jan 2023