Evidence map›Paper›PMID 26712807›Full record

SynthesisClinical journal of the American Society of Nephrology : CJASN2016

Effect of Lowering the Dialysate Temperature in Chronic Hemodialysis: A Systematic Review and Meta-Analysis.

Reem A Mustafa, Fadi Bdair, Elie A Akl, Amit X Garg, Heather Thiessen-Philbrook, Hassan Salameh, Sood Kisra, Gihad Nesrallah, Ahmad Al-Jaishi, Parth Patel and 3 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  12. Trial
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  15. Randomized trial comparing standard versus thermocontrolled haemodialysis using intradialytic cardiac, brain and renal magnetic resonance imaging.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024
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  16. Trial
  17. Observational
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  19. A Narrative Summary of Strategies to Mitigate Intradialytic Hypotension in Poisoned Patients Requiring Extracorporeal Toxin Elimination.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026
    Review
  20. Article

4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Reem A MustafaDepartments of Clinical Epidemiology and Biostatistics and Departments of Medicine and Biomedical and Health Informatics and ramustafa@gmail.com.
Fadi BdairDepartments of Medicine and Biomedical and Health Informatics and.
Elie A AklDepartments of Clinical Epidemiology and Biostatistics and Department of Internal Medicine, American University of Beirut, Beirut, Lebanon;
Amit X GargDepartments of Clinical Epidemiology and Biostatistics and Department of Medicine, London Health Sciences Centre, London, Ontario, Canada; Department of Medicine, Western University, London, Ontario, Canada;
Heather Thiessen-PhilbrookProgram of Applied Translational Research, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut;
Hassan SalamehDepartments of Medicine and Biomedical and Health Informatics and.
Sood KisraDepartments of Medicine and Biomedical and Health Informatics and.
Gihad NesrallahLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada;
Ahmad Al-JaishiDepartment of Medicine, London Health Sciences Centre, London, Ontario, Canada;
Parth PatelMD Program, St. James School of Medicine, Chicago, Illinois; and.
Payal PatelSchool of Medicine, University of Missouri, Kansas City, Missouri;
Ahmad A MustafaSchool of Medicine, Jordan University of Science and Technology, Erbid, Jordan.
Holger J SchünemannDepartments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada;

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesLowering the dialysate temperature may improve outcomes for patients undergoing chronic hemodialysis. We reviewed the reported benefits and harms of lower temperature dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched the Cochrane Central Register, OVID MEDLINE, EMBASE, and Pubmed until April 15, 2015. We reviewed the reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included all randomized, controlled trials that evaluated the effect of reduced temperature dialysis versus standard temperature dialysis in adult patients receiving chronic hemodialysis. We followed the Grading of Recommendations Assessment, Development and Evaluation approach to assess confidence in the estimates of effect (i.e., the quality of evidence). We conducted meta-analyses using random effects models.

resultsTwenty-six trials were included, consisting of a total of 484 patients. Compared with standard temperature dialysis, reduced temperature dialysis significantly reduced the rate of intradialytic hypotension by 70% (95% confidence interval, 49% to 89%) and significantly increased intradialytic mean arterial pressure by 12 mmHg (95% confidence interval, 8 to 16 mmHg). Symptoms of discomfort occurred 2.95 (95% confidence interval, 0.88 to 9.82) times more often with reduced temperature compared with standard temperature dialysis. The effect on dialysis adequacy was not significantly different, with a Kt/V mean difference of -0.05 (95% confidence interval, -0.09 to 0.01). Small sample sizes, loss to follow-up, and a lack of appropriate blinding in some trials reduced confidence in the estimates of effect. None of the trials reported long-term outcomes.

conclusionsIn patients receiving chronic hemodialysis, reduced temperature dialysis may reduce the rate of intradialytic hypotension and increase intradialytic mean arterial pressure. High-quality, large, multicenter, randomized trials are needed to determine whether reduced temperature dialysis affects patient mortality and major adverse cardiovascular events.

Indexed as

Cold TemperatureArterial PressureChi-Square DistributionHemodialysis SolutionsHumansHypertensionHypotensionOdds RatioRenal DialysisRenal Insufficiency, ChronicRisk FactorsTreatment OutcomeHemodialysis Solutionschronic hemodialysiscold temperaturedialysisdialysis solutionsend stage renal diseasefollow-up studieshemodialysishumanshypotensionrenal dialysis

Identifiers

PMID26712807
PMCPMC4791810

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.