Staff Members - Benha University
Minimizing Myocardial Ischemic Injury by Cool dialysate in maintenance hemodialysis patients: A Randomized Controlled Trial
• 2021
Publication Information
Authors
El-MetwalLy Lotfy El-Shahawy, Hassan Galal Abdelsalam, Ashraf Talaat Mahmoud, Mohamed El Tantawy Ibrahim, and Heba Ahmed Mohamed Mokhtar
Keywords
Not Available
Journal
Not Available
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
Local
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Background: Emerging evidence supports a cardiovascular protective role of Cooled Dialysis (CD) in incident Hemodialysis (HD) patients, whether this benefit can be extended to maintenance HD patients remains to be established.
Aim and objectives: The aim of the present study was to assess the impact of CD by lowering Dialysate temperature (dt) 0.5 ℃ below Core Body Temperature (CBT), on minimizing myocardial ischemia in maintenance HD patients (>1 year on HD).
Patients and Methods: from March 2019 to January 2021, we randomized one hundred maintenance HD patients to receive either Cooled Dialysis (dt - 0.5 ℃ below CBT, intervention) or Standard Dialysis (dt= CBT, control) for 12 months. Over the study period, serial measurements of ECG, Echocardiography, and myocardial enzymes (CK-MB & Troponin-T) were performed for the whole study population as surrogates for myocardial ischemic injury.
Results: By the end of 12-months, compared to Standard Dialysis (ST) patients, Cooled Dialysis (CD) patients had overall less incidence of new myocardial ischemia (composite surrogate outcomes: ECG, Echo and CK-MB) (p=0.032). In logistic regression analysis, CD was found to be independently protective against myocardial ischemia ((OR 0.54, p-value 0.033, CI: 0.3-0.95).
Conclusion: In maintenance HD patients, Cooled Dialysis might help decrease myocardial ischemia with a reasonable safety profile. Further studies are warranted to explore these findings.
Aim and objectives: The aim of the present study was to assess the impact of CD by lowering Dialysate temperature (dt) 0.5 ℃ below Core Body Temperature (CBT), on minimizing myocardial ischemia in maintenance HD patients (>1 year on HD).
Patients and Methods: from March 2019 to January 2021, we randomized one hundred maintenance HD patients to receive either Cooled Dialysis (dt - 0.5 ℃ below CBT, intervention) or Standard Dialysis (dt= CBT, control) for 12 months. Over the study period, serial measurements of ECG, Echocardiography, and myocardial enzymes (CK-MB & Troponin-T) were performed for the whole study population as surrogates for myocardial ischemic injury.
Results: By the end of 12-months, compared to Standard Dialysis (ST) patients, Cooled Dialysis (CD) patients had overall less incidence of new myocardial ischemia (composite surrogate outcomes: ECG, Echo and CK-MB) (p=0.032). In logistic regression analysis, CD was found to be independently protective against myocardial ischemia ((OR 0.54, p-value 0.033, CI: 0.3-0.95).
Conclusion: In maintenance HD patients, Cooled Dialysis might help decrease myocardial ischemia with a reasonable safety profile. Further studies are warranted to explore these findings.