Do advances in hemodialysis machine technology translate to improved patient outcomes? (part 1)

Intradialytic hypotension is the commonest complication in routine outpatient hemodialysis practice, and reduction in myocardial perfusion during hemodialysis has been associated with increased mortality risk. Repetitive episodes of hypotension also risk cerebral ischaemic damage and may also potentially cause ischaemic to other perfusion-dependent organs,including the pancreas and the gut. Maintenance of the initial body temperature at the commencement of dialysis will minimize intradialytic instability and complications, but in those patients who develop significant intradialytic hypotension, lowering the dialysate temperature may be beneficial. Cool temperature dialysate typically uses 35ºC. Deliberate cooling of the dialysate was shown to reduce intradialytic hypotension and diminishes cardiac stunning compared with isothermic dialysis and risk of hypotension.