الفهرس 
Factors Affecting Dialysis AdequacyOnly 14 pages are availabe for public view
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Abstract
Dialysate temperature is an easy maneuver which can change the blood temperature, a surrogate of body
core temperature. Warm dialysate can increase the body core temperature, resulting in vasodilation and increased mobilization of sequestered toxins to intravascular compartment ( Selby and McIntyre, 2006).
Cool dialysate induced vasoconstriction may reduce the toxin mobilization from remote inaccessible body compartments to intravascular compartment, thus hindering the toxin removal, which is contrary to the fundamental objective of HD. Hence, although cool dialysate helps in prevention of intra-dialytic episodes in short-term, prolonged usage may lead to poor patient outcome by impaired toxin removal (Duranton et al., 2014).
We aimed at determining the effect of varied temperature dialysate on small sized toxins removal in haemodialysis patients and evaluate the effect of varied temperature dialysate on patients’ perception.
Total 80 subjects were recruited for the study. Patients recruited in this study were divided into four groups; patients underwent HD sessions using dialysate which temperatures were (35 ⁰C, 35.5⁰C, 36⁰C, 36.5⁰C).
All patients were subjected to history taking and clinical examination. During each study session, pre- and post-dialysis blood samples were collected; These samples were analyzed for small -sized uremic toxins, namely, urea and creatinine. The pre- and post-dialysis blood samples were used for calculating the toxin reduction ratio; URR=100 (initial urea level-post
dialysis level)/initial level.
Patients’ perceptions about their experiences of the cool temperature dialysate were measured after completion of the dialysis session by means of a questionnaire.
Also our study studied the difference between basal body temperature of the patients and dialysate temperature in relation to urea reduction ratio as the patients were divided into 3 groups:
(temp < 0.5 °C, temp ≥ 0.5 - 1 °C and temp > 1 °C)
and showed that the highest urea reduction ratio was among patients in whom dialysate temp differs from basal body temp by a range of 0.5 to 1 °C.
In conclusion, Cool dialysis has no bad effect on adequacy of dialysis in form of urea reduction ratio, it even improved with dialysate temperature 35.5 °C Also showed that the highest urea reduction ratio was among patients in whom dialysate temp differs from basal body temp by a range of 0.5 to 1 °C. So consider low dialysate temperature benefits irrespective of fear of dialysis inadequacy.
Despite tolerability of low dialysate temperature; it may be advisable to be in range of 36-36.5° C for patients convenience.
We recommend to advice of low dialysate temperature according to clinical situations without fear of compromising dialysis adequacy.
Suitable decrease of dialysate temperature is by a range of 0.5 to 1 °C from basal body temperature, taking in consideration patient acceptance and tolerability.