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

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 I...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Mona Elsayyad, Moustafa Abdelsalam, Osama Ahmad, Ehab Eltoraby, Mona Abdelhady
Formato: article
Lenguaje:EN
Publicado: Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:
Acceso en línea:https://doaj.org/article/2f8ff521847a48f1b1f2ebe14e6188be
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:2f8ff521847a48f1b1f2ebe14e6188be
record_format dspace
spelling oai:doaj.org-article:2f8ff521847a48f1b1f2ebe14e6188be2021-12-02T15:42:47ZShort-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists2636-41742682-378010.21608/ijma.2021.50763.1244https://doaj.org/article/2f8ff521847a48f1b1f2ebe14e6188be2021-04-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_152625_f18a3e33f26921ba5924b8a720b0181d.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: 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.Mona ElsayyadMoustafa AbdelsalamOsama AhmadEhab EltorabyMona AbdelhadyAl-Azhar University, Faculty of Medicine (Damietta)articlecoolhemodialysishypotensionpruritusadequacyMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 2, Pp 1257-1265 (2021)
institution DOAJ
collection DOAJ
language EN
topic cool
hemodialysis
hypotension
pruritus
adequacy
Medicine (General)
R5-920
spellingShingle cool
hemodialysis
hypotension
pruritus
adequacy
Medicine (General)
R5-920
Mona Elsayyad
Moustafa Abdelsalam
Osama Ahmad
Ehab Eltoraby
Mona Abdelhady
Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists
description 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.
format article
author Mona Elsayyad
Moustafa Abdelsalam
Osama Ahmad
Ehab Eltoraby
Mona Abdelhady
author_facet Mona Elsayyad
Moustafa Abdelsalam
Osama Ahmad
Ehab Eltoraby
Mona Abdelhady
author_sort Mona Elsayyad
title Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists
title_short Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists
title_full Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists
title_fullStr Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists
title_full_unstemmed Short-term Individualized Dialysate Cooling in Chronic Hemodialysis: Therapeutic benefits for Patients and A favorite choice for Nephrologists
title_sort short-term individualized dialysate cooling in chronic hemodialysis: therapeutic benefits for patients and a favorite choice for nephrologists
publisher Al-Azhar University, Faculty of Medicine (Damietta)
publishDate 2021
url https://doaj.org/article/2f8ff521847a48f1b1f2ebe14e6188be
work_keys_str_mv AT monaelsayyad shorttermindividualizeddialysatecoolinginchronichemodialysistherapeuticbenefitsforpatientsandafavoritechoicefornephrologists
AT moustafaabdelsalam shorttermindividualizeddialysatecoolinginchronichemodialysistherapeuticbenefitsforpatientsandafavoritechoicefornephrologists
AT osamaahmad shorttermindividualizeddialysatecoolinginchronichemodialysistherapeuticbenefitsforpatientsandafavoritechoicefornephrologists
AT ehabeltoraby shorttermindividualizeddialysatecoolinginchronichemodialysistherapeuticbenefitsforpatientsandafavoritechoicefornephrologists
AT monaabdelhady shorttermindividualizeddialysatecoolinginchronichemodialysistherapeuticbenefitsforpatientsandafavoritechoicefornephrologists
_version_ 1718385800623685632