[Chisca]

During hemodialysis one method of improving blood pressure is reducing the temperature of the dialysate to 35-36 degrees c. What about warming dialysate for patient comfort? I am aware of literature that describes the risks of hemolysis with increased temps but none state at what temperature this would occur. Many patients complain of being cold and the typical response is more blankets. Would increasing dialysate temperature help?

[onyx77]

I don't have a complete answer for you, as I am a new grad. But, I had part of my clinical in the dialysis center (28 hrs) this last semester and the first time that I heard anyone talk about changing the temp on the dialysate was on my last day there. It seemed that a client complained of being cold and the temp was increased and about 30 minutes later the same client c/o being too warm and the dialysate temp was lowered. So, I guess it can be done, but that is the extent of my knowledge on the subject. Hopefully someone else will have a straight answer for us!

[Chisca]

So now I see there is a renal sub forum. If a moderator wants to move this thread there I would appreciate it. Thanks for your reply onyx77.

[LiverpoolJane]

The policy at the unit I work on is that the machines' temp is defaulted to 36.5c I have been asked by patients to increase it and I really don't like doing so - I am more inclined to reduce if anything to try and reduce the risk of hypovolaemia etc. If I have increased at all it is only to 37.0c - but that is not evidenced based, I just feel that you wouldn't want to increase the machine temp higher than normal body temp!?
I have several articles on dialysate temp - I could try and locate them and if you wanted copies I could scan them and e-mail them to you?

[Tweety]

Originally Posted by Chisca

So now I see there is a renal sub forum. If a moderator wants to move this thread there I would appreciate it. Thanks for your reply onyx77.

Done.

[Chisca]

Originally Posted by LiverpoolJane

The policy at the unit I work on is that the machines' temp is defaulted to 36.5c I have been asked by patients to increase it and I really don't like doing so - I am more inclined to reduce if anything to try and reduce the risk of hypovolaemia etc. If I have increased at all it is only to 37.0c - but that is not evidenced based, I just feel that you wouldn't want to increase the machine temp higher than normal body temp!?
I have several articles on dialysate temp - I could try and locate them and if you wanted copies I could scan them and e-mail them to you?

Good points. Why does the machine (Fresenius) allow a range from 35 to 39 degrees? In what scenario would you want to set it higher than body temp? All the articles I have seen on temp refer to lower temps to prevent hypotension, I would appreciate any evidence based info you might have.

[jnette]

Here you go.. you might find this answers some of your questions.

http://uninet.edu/cin2001/html/conf/...schneditz.html

http://www.kidney.org/professionals/...radialytic.htm

[Chisca]

The second article refers to "standard dialysate-temperature (37–38°C)
38 degrees would definitely be above most patients body temp. Core body temps are not routinely measurable unless a bladder temp or PA catheter is available. The focus remains on cold dialysate temps to deal with hypotension. By it's very nature an extra-corporeal blood circuit is going to cool the body.