London-based study examines optimal dialysis temperature in largest trial to date

Results from the largest clinical trial of hemodialysis conducted by scientists in London showed no increased benefit from using cooler temperatures, although earlier research suggested otherwise.

MyTemp study, published in Medical Weekly Lancetincluding trial results from Lawson Health Research Institute, ICES Western, and Western University, found that lowering dialysis temperature did not improve patient outcomes for cardiovascular-related death and hospitalization, nor did it maintain better blood pressure during treatment.

“These studies are limited, especially in number, but the practice of lowering dialysis temperatures has become an increasingly popular practice. Some institutions have even made it a center-wide policy for all hemodialysis patients,” Lau said. said Dr. Amit Garg, Mori scientist, ICES Western site director, and associate dean for clinical research at the Schulich School of Medicine and Dentistry. He also works as a nephrologist at the London Health Sciences Centre (LHSC), specialising in the treatment and diagnosis of kidney disease.

Over the past four years, researchers studied the outcomes of standard dialysis and hypothermic dialysis treatments in more than 15,000 patients at 84 of Ontario’s 97 hemodialysis centers. Ten of these centers operate through the LHSC. In terms of patient numbers, the study is the largest of its kind published to date.

The trial included a total of 4.3 million dialysis treatments. Patients were randomly assigned to receive standard temperature or hypothermia 0.5°C to 0.9°C below each patient’s measured predialysis body temperature, with a minimum recommended temperature of 35.5°C.

“We wanted to determine whether lowering the dialysis temperature could help people live longer and healthier lives,” Garg said. “We also measured symptoms and how people felt about dialysis. We set out to gather high-quality evidence to make sure we were doing the right thing for our patients.”

Garg said the researchers did not find any benefit in patients receiving the colder treatment. Cardiovascular health did not improve, and some people actually said they felt sick from lower dialysis temperatures.

“The results suggest that we should not make lower dialysis temperatures a center-wide policy and its utility in specific patient care deserves scrutiny,” Garg added.

According to the Canadian Kidney Foundation, 1 in 10 Canadians has kidney disease. Most kidney diseases attack the filtering units of the kidneys, the nephrons, which impair their ability to eliminate waste and excess fluid. Kidney disease can range from mild to severe, sometimes leading to kidney failure.

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