Findings from the largest dialysis clinical trial conducted by scientists in London show that using lower temperatures has no increased benefits, despite earlier studies suggesting otherwise. The MyTemp study, published in the Lancet weekly medical journal, included findings from the trial through the Lawson Health Research Institute, ICES Western and Western University and found that lowering dialysis temperatures did not improve patient outcomes when it came to deaths and hospitalizations associated with cardiovascular disease. nor does it maintain better blood pressures during treatment. “Studies have been limited, especially in numbers, yet the practice of lowering the dialysis temperature has become a practice that is growing in popularity. Some institutions have even made it a center-wide policy for all dialysis patients,” said Dr. Amit Garg, Lawson scientist, site director for ICES Western and associate dean for clinical research at the Schulich School of Medicine and Dentistry. He also works as a nephrologist, which is someone who specializes in the treatment and diagnosis of kidney disorders, at the London Health Sciences Center (LHSC). Over the past four years, researchers studied the results of both standard and cold dialysis treatments in more than 15,000 patients at 84 of 97 dialysis centers in Ontario. Ten of the centers were operated through the LHSC. In terms of patient numbers, the study is the largest of its kind ever published. The trial included a total of 4.3 million dialysis treatments. Patients were randomized to receive treatment with either the standard temperature or a reduced temperature of 0.5 C to 0.9 C below each patient’s measured body temperature before hemodialysis, with the lowest recommended temperature of 35.5 C. “We wanted to determine whether lowering the dialysis temperature would help people live longer and healthier lives,” Garg said. “We also measured symptoms and how people felt on dialysis. We set out to collect high-quality evidence to make sure we’re doing the right thing for patients.” Garg said the researchers found no benefit for patients given colder treatments. There were no improvements in cardiovascular health and some actually said they felt discomfort from the reduced dialysis temperature. “The results suggest that we should not adopt lower dialysis temperatures as a center-wide policy, and its utility in selected patient care requires testing,” Garg added. According to the Kidney Foundation of Canada, 1 in 10 Canadians lives with kidney disease. Most kidney diseases affect the kidney’s filtering units, known as nephrons, which can impair their ability to remove waste and excess fluid. Kidney disease can range from mild to severe and can sometimes lead to kidney failure.
