الفهرس 
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Abstract
Summary & Conclusion
SUMMARY AND CONCLUSION Summary:
This study was carried out to compare the effects of low-temperature dialysis and the standard-temperature hemodialysis on clinical, laboratory and blood gases in patients with end stage renal failure.
This study was carried out on 20 patients with end stage renal failure under maintenance regular hemodialysis, they included 11 males and 9 females, their ages ranged between 25 years and 62 years with a mean age 43.4 ± 8.4 years. Patients were chosen from International Mansoura Hospital (hemodialysis unit). Patients were assessed during twenty dialysis sessions, ten session with dialysate temperature 37°C and next ten session with dialysate temperature 35°C. Blood pressure and blood gases were assessed every 15 minutes. Also the serum electrolytes (Na, K, Ca & PO4), serum urea and creatinine were assessed before and after each session.
This study showed that:
1) Cool dialysis (at 35°C) improved hypoxia as a significant complication of the hemodialysis at the standard dialysate temperature (37°C) Pa02 with dialysate temperature 37°C versus Pa02 at dialysate temperature 35°C were: at 15 minutes, 97.21 ± 11.675 versus 100.87 ± 9.45 (P < 0.001); at 30 minutes, 95.44 ± 11.832 versus 99.65 ± 1.642 (P < 0.001); at 240 minutes 99.49 ± 8.547 versus 99.64 ± 10.42 (P < 0.05).
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Summary & Conclusion
2)In cool dialysis no significant decrease in PaCO2 that occurs at the standard dialysis temperature. PaCO2 at dialysate temperature 37°C versus PaCO2 at dialysate temperature 35°C were: at 15 minutes 35.21 ± 3.252 versus 35.61 ± 1.36 (P < 0.05); at 30 minutes 35.18 ± 2.232 versus 35.68 f 1.94 (P < 0.05); at 240 minutes 33.83 ± 0.808 versus 35.22 ± 2.18 (P < 0.05).
3)PH increases with both cool and standard dialysis but more evident with 35°C — dialysate temperature. PH at dialysate temperature 37°C versus pH at dialysate temperature 35°C were: at 15 minutes 7.332 ± 0.032 versus 7.326 ± 0.068 (P > 0.05); at 30 minutes 7.337 ± 0.042 versus 7.332 ± 0.066 (P > 0.05); at 240 minutes 7.431 ± 0.048 versus 7.512 ± 0.046 (P < 0.05).
4)The leukopenia that occur at the start of the dialysis session and the rebound leukocytosis decreased with cool dialysis. Total leucocytic count (TLC) at dialysate temperature 37°C versus TLC at dialysate temperature 35°C were: at 15 minutes 2321 ± 976 versus 3978 ± 678 (P < 0.001); at 30 minutes 3884 ± 911 versus 4064 ± 882 (P < 0.001); at 240 minutes 6804 ± 2160 versus 6120 ± 840 (P < 0.001).
5)No significant changes present between the electrolyte disturbances
that occurred in both 37°C and 35°C dialysate temperature.
Na at dialysate temperature 37°C versus Na at dialysate temperature 35°C were: predialysis session 138.8 ± 3.8 versus 138 f 3.2; postdialysis session 140.3 ± 2.01 versus 141.6 ± 3.4 (P > 0.05).
K at dialysate temperature 37°C versus K at dialysate temperature 35°C were: predialysis session 6.4 ± 0.42 versus 4.7 ± 0.34; postdialysis session 3.5 ± 0.62 versus 3.6 ± 0.53 (P > 0.05).
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Summary & Conclusion
Ca at dialysate temperature 37°C versus Ca at dialysate temperature 35°C were: predialysis session 8.9 ± 1.60 versus 8.8 ± 0.95; postdialysis session 9.3 ± 1.10 versus 9.3 ± 1.1 (P > 0.05).
PO4 at dialysate temperature 37°C versus K at dialysate temperature 35°C were: predialysis session 4.26 ± 0.043 versus 4.31 ± 0.685; postdialysis session 4.19 ± 0.535 versus 4.22 ± 0.63 (P > 0.05).
6) Cool dialysis improve intradialytic hemodynamics and prevent dialysis-associated hypotension. Blood pressure change during and after session of dialysis at dialysate temperature 37°C versus at dialysate temperature 35°C were:
Systolic blood pressure (SBP) at first hour 138.2 ± 17.4 versus 140.5 ± 18.6 (P > 0.05).
Diastolic blood pressure (DBP) at first hour 80.3 ± 9.7 versus 85 ± 10.2 (P > 0.05).
Systolic blood pressure (SBP) at second hour 135.8 ± 9.1 versus 135 ± 15.8 (P > 0.05).
Diastolic blood pressure (DBP) at second hour 80.2 ± 9.6 versus 80 ± 9.8 (P > 0.05).
-Systolic blood pressure (SBP) at third hour 128 ± 12.2 versus 118.5 ± 13.8 (P < 0.05).
Diastolic blood pressure (DBP) at third hour 79.2 ± 9.1 versus 70.4 ± 8.7 (P < 0.05).
-Systolic blood pressure (SBP) at fourth hour 125.5 ± 20.2 versus 110.5 ± 19.3 (P < 0.05).
Diastolic blood pressure (DBP) at fourth hour 74.6 ± 9.4 versus 65.8 ± 8.5 (P < 0.05).
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Summary & Conclusion Conclusion:
Cool dialysis has a beneficial effect to patient with chronic renal failure under maintenance hemodialysis with frequent hypoxemia.