Key result
Individualised body temperature dialysis reduced the mean number of peak stress regional wall motion abnormalities compared to 37°C dialysis (3.9 vs 5.3, p=0.03).
Why the study?
Does individualised body temperature haemodialysis reduce myocardial stunning and improve haemodynamic stability in patients undergoing haemodialysis?
RCT (n=11)
Crossover
Does individualised body temperature haemodialysis reduce myocardial stunning and improve haemodynamic stability in patients undergoing haemodialysis?
Absolute Event Rate: 3.9% vs 5.3%
p-value: p=0.03
Individualised-temperature haemodialysis reduces myocardial stunning and improves haemodynamic stability without compromising tolerability.
Supports individualised-temperature haemodialysis to limit myocardial stunning; extends prior data with RCT confirmation in dialysis patients.
BACKGROUND/AIMS: Haemodialysis-induced myocardial stunning is associated with intradialytic hypotension, increased likelihood of cardiovascular events and death. Dialysis at 35°C reduces stunning, but adverse thermal symptoms limit technique adoption. This study investigated whether individualised body temperature dialysis improves haemodynamic stability and abrogates stunning. METHODS: Randomised crossover study of 11 patients compared LV regional wall motion abnormalities (RWMAs) at 37°C (HD(37)) and body temperature ('individualised', HD(ind)). Regional systolic function was quantitatively assessed by echocardiography. Haemodynamics were assessed using continuous pulse wave analysis. Thermal symptoms were scored by questionnaire. RESULTS: Mean predialysis body temperature was 36.0 ± 0.1°C. Mean number of peak stress RWMAs per patient was lower with HD(ind) (3.9 ± 1.4 vs. 5.3 ± 1.5, p = 0.03). Intradialytic systolic BP was higher during HD(ind) versus HD(37) (p < 0.001). Individualised body temperature dialysis demonstrated symptomatic tolerability comparable to HD(37). CONCLUSIONS: Individualised-temperature haemodialysis abrogates stunning, providing effective haemodynamic stabilisation at no additional therapy cost.
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Jefferies et al. (2011) conducted an RCT in Haemodialysis (n=11). Individualised body temperature dialysis vs. Dialysis at 37°C was evaluated on Mean number of peak stress regional wall motion abnormalities (RWMAs) per patient (p=0.03). Individualised body temperature dialysis reduced the mean number of peak stress regional wall motion abnormalities compared to 37°C dialysis (3.9 vs 5.3, p=0.03).
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