The Effect of Dialysate Temperature on Urea Reduction Ratio among Patients Undergoing Maintenance Haemodialysis: A Case Control Study

Abstract

Introduction: Lowering the dialysate temperature in Intradialytic Hypotension (IDH) prone Maintenance Haemodialysis (MHD) patients, offers better haemodynamic stability. Evidence is lacking relating the effects of low dialysate temperature on urea clearance. Aim: To study the effect of dialysate temperature on dialysis adequacy in terms of urea reduction ratio in MHD patients. Materials and Methods: This experimental study was conducted on stable End Stage Renal Disease (ESRD) patients undergoing regular MHD in the age group of 18 to 65 years. The study population (n=118) was randomly divided into two groups. In the control group (n=59), the dialysate temperature was set at 37°C and in the study group (n=59), the temperature was set at 35.5°C. Urea Reduction Ratio (URR) and Online Clearance Monitoring (OCM) Kt/V of individual Haemodialysis (HD) sessions in both the groups were calculated and compared. Results: The mean pre and post Blood Urea Nitrogen (BUN) values of HD sessions in the control group were 49.95±19.54 mg/dL and 14.17±7.92 mg/dL respectively. The mean pre and post BUN values of HD sessions in the study (low dialysate temperature) group were 50.76±17.67 mg/dL and 21.69±10.96 mg/dL respectively. The mean URR of HD sessions of the control group was 69.08±14.72 and in the study group, it was 56.93±15.85. In the low dialysate temperature group, 43 (72.9%) patients achieved 65% URR. Conclusion: Dialysis with low dialysate temperature was associated with statistically significant reduction of URR. Low dialysate temperature can affect dialysis adequacy in stable MHD patients.

Keywords

• blood urea nitrogen
• cool dialysate
• dialysate temperature
• online clearance monitoring