Simultaneous blood temperature control and blood volume control reduces intradialytic symptoms

Int J Artif Organs. 2011 Apr;34(4):357-64. doi: 10.5301/IJAO.2011.7746.


Purpose: Intra-dialytic morbid events (IME; e.g. hypotension, cramps, headaches) are frequent complications during hemodialysis (HD), known to be associated with ultrafiltration-induced hypovolemia and body temperature changes. Feedback control of blood volume adjusts the ultrafiltration rate in order to keep the blood volume above the patient's individual limit; feedback control of blood temperature maintains the mean arterial blood temperature at the individual pre-dialytic level. Each of these methods reduces the frequency of IME.

Methods: In a randomized clinical trial the simultaneous application of both feedback controls was investigated for the first time. In 15 weeks, each patient went through 3 study phases: an observational screening phase, a standard phase (STD), and a blood temperature- and blood volume-control phase (CTL). Patients with at least 5 sessions with IME out of 15 sessions in the screening phase were eligible for the study and randomized either into sequence STD-CTL or CTL-STD.

Results: 26 patients completed the study according to protocol, and 778 HD treatments were analyzed. The general treatment parameters were similar in both study phases: treatment duration (STD: 244 min, CTL: 243 min, NS), pre-dialytic weight (STD: 72.3 kg, CTL: 72.2 kg, NS), and weight loss due to ultrafiltration (STD: 3.26 kg, CTL: 3.15 kg, NS). The proportion of HD treatments with IME was 32.8% during STD and 18.0% during CTL (p=0.024).

Conclusions: The frequency of HD sessions with IME was significantly reduced by 45% compared to standard HD in this randomized clinical trial by use of individualized HD treatments with simultaneous feedback control of blood volume and blood temperature.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Automation
  • Blood Volume Determination* / instrumentation
  • Blood Volume*
  • Body Temperature Regulation*
  • Cross-Over Studies
  • Diagnostic Equipment
  • Equipment Design
  • Europe
  • Feedback
  • Female
  • Headache / etiology
  • Headache / prevention & control
  • Humans
  • Hypotension / etiology
  • Hypotension / prevention & control
  • Hypovolemia / blood
  • Hypovolemia / diagnosis
  • Hypovolemia / etiology
  • Hypovolemia / physiopathology
  • Hypovolemia / prevention & control*
  • Male
  • Middle Aged
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / methods*
  • Muscle Cramp / etiology
  • Muscle Cramp / prevention & control
  • Predictive Value of Tests
  • Prospective Studies
  • Renal Dialysis / adverse effects*
  • Signal Processing, Computer-Assisted
  • Thermometers
  • Time Factors
  • Treatment Outcome