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Nephrol Dial Transplant (2001) 16: 7-9
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Keep your temper: how to avoid heat accumulation in haemodialysis

Daniel Schneditz,1 and Nathan W. Levin2

1 Department of Physiology, Karl-Franzens University, Graz, Austria and 2 Renal Research Institute, New York, NY, USA

There is considerable interest in temperature balance during haemodialysis because of the well documented effect of warm dialysate on haemodynamic stability [1–4]. Even though haemodialysis does not lead to direct heat transfer from the extracorporeal circulation to the patient in most cases, patient temperatures tend to increase during treatments using conventional dialysate temperatures. What is the cause for the increase in body temperature often seen during haemodialysis?

Extracorporeal factors

Extracorporeal heat flow is determined by dialysate temperature, arterial blood temperature (a good representation of patient core temperature), blood flow, environmental temperature, length and insulation characteristics of the venous blood line, and ultrafiltration. Even though dialysate temperature governs the temperature of blood leaving the dialyser, it is the temperature of venous blood entering the access that determines the extracorporeal arterio-venous temperature gradient. Venous blood temperature entering the patient decreases with decreasing extracorporeal blood flow because of increased exposure to . . . [Full Text of this Article]

Patient temperature

Haemodynamic compensation

Pyrogen hypothesis

Direct effect of ultrafiltration

Indirect effect of ultrafiltration

Blood temperature monitor

Conclusion

Notes

References


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