Medizinische Universität Graz - Research portal
Selected Publication:
Rosales, LM; Schneditz, D; Morris, AT; Rahmati, S; Levin, NW.
Isothermic hemodialysis and ultrafiltration.
Am J Kidney Dis. 2000; 36(2):353-361
Doi: 10.1053/ajkd.2000.8986
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Schneditz Daniel
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- Abstract:
- The increase in patient temperature during hemodialysis is explained by hemodynamic compensation during ultrafiltration and hypovolemia that leads to peripheral vasoconstriction and reduced heat losses. We analyzed 51 stable high-efficiency hemodialysis treatments in 27 patients during isothermic dialysis in which body temperature was maintained at a constant level (+/-0.1 degrees C) using the temperature-control option of the Blood Temperature Monitor (BTM; Fresenius Medical Care, Bad Homburg, Germany). Hemodialysis was delivered using ultrapure water (limulus amebocyte lysate test < 0. 06 endotoxin units/mL) at mean blood flows of 410 +/- 40 mL/min. During treatments lasting 178 +/- 23 minutes, 4.8% +/- 1.4% of postdialysis body weight (W%) and 9.5% +/- 2.5% of postdialysis body water were removed using mean ultrafiltration rates of 1.1 +/- 0.3 L/h. Dialysate temperatures significantly decreased from 35.9 degrees C +/- 0.3 degrees C to 35.6 degrees C +/- 0.6 degrees C during hemodialysis. During these treatments, 187 +/- 69 kJ of thermal energy were removed from the patients through the extracorporeal circulation using cool dialysate. Extracorporeal heat flow was 17 +/- 6 W. Energy expenditure (H) estimated from anthropometric data was 65 +/- 12 W. Thus, 28% +/- 10% of estimated energy expenditure (H%) was removed during isothermic dialysis. A highly significant correlation was observed between H% and W% (H% = -5.6 * W%; r(2) = 0.91; P < 0.0001). This result is in support of the volume hypothesis of intradialytic heat accumulation and provides a rule of thumb to estimate extracorporeal cooling requirements for isothermic dialysis. Approximately 6% of H must be removed through the extracorporeal circulation for each percent of ultrafiltration-induced body-weight change. The importance of body temperature control during hemodialysis increases with increased ultrafiltration requirements.
- Find related publications in this database (using NLM MeSH Indexing)
- Body Temperature -
- Body Weight -
- Energy Metabolism -
- Female -
- Heat -
- Humans -
- Male -
- Middle Aged -
- Renal Dialysis - methods
- Temperature - methods
- Find related publications in this database (Keywords)
- hemodialysis (HD)
- dialysate temperature
- ultrafiltration
- heat accumulation
- vasoconstriction
- heat loss