Effect of Cold Dialysate on Intradialytic Blood Pressure

Background: Even in patients who are susceptible to intradialytic hypotension (IDH), cold dialysate temperatures enhance hemodynamic tolerance during and after haemodialysis (HD) without negatively impacting dialysis adequacy. Objective: The purpose of this study was to assess how reducing the temperature of the dialysate affected the intradialytic blood pressure (BP). Patients and Methods: 50 patients of both sexes older than 18 years were included in this prospective cross-over research. All patients were subjected to BP measuring and follow-up pre- and post-dialysis for six sessions, three on cold dialysate (35.50 oC) and another three dialysis sessions on normal temperature dialysate (37 oC). Two studies must be separated by at least one week. A minimum of one week is kept between sessions to prevent any residual effects from the previous research session. The study was done in midweek sessions to avoid excessive ultrafiltration, BP, pulse, and temperature were measured every hour for the four hours duration of the session recorded and compared cold versus normal temperature dialysate sessions. Results: Post dialysis blood urea nitrogen was significantly lower at cold dialysate than normal temperature dialysate (P <0.001). Mean arterial BP (MAP) was significantly lower at C2 in pre dialysis than post dialysis (P =0.018). Systolic BP (SPB), diastolic BP (DPB) and MAP were significantly higher at cold dialysate sessions (C1, C2 and C3) than normal temperature dialysate (P <0.001). MAP was insignificantly different at C1and C3 between pre dialysis and post dialysis. Conclusions: It could be concluded that cold dialysate improves intradialytic hypotension compared to patients who have undergone normal temperature dialysate.