Separate and combined effects of cold dialysis and intradialytic exercise on the thermoregulatory responses of hemodialy
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RESEARCH ARTICLE
Open Access
Separate and combined effects of cold dialysis and intradialytic exercise on the thermoregulatory responses of hemodialysis patients: a randomized-crossover study Argyro A. Krase1,2, Andreas D. Flouris1, Christina Karatzaferi2, Christoforos D. Giannaki3, Ioannis Stefanidis4 and Giorgos K. Sakkas2,5*
Abstract Background: The separate and combined effects of intradialytic exercise training (IET) and cold dialysis (CD) on patient thermoregulation remain unknown. This study assessed the thermoregulatory responses of hemodialysis patients under four different hemodialysis protocols: a) one typical dialysis (TD) protocol (dialysate temperature at 37 °C), b) one cold dialysis (CD) protocol (dialysate temperature at 35 °C), c) one typical dialysis protocol which included a single exercise bout (TD + E), d) one cold dialysis protocol which included a single exercise bout (CD + E). Methods: Ten hemodialysis patients (57.2 ± 14.9 years) participated in this randomized, cross-over study. Core and skin temperatures were measured using an ingestible telemetric pill and by four wireless iButtons attached on the skin, respectively. Body heat storage (S) calculated using the thermometric method proposed by Burton. Results: The TD and TD + E protocols were associated with increased S leading to moderate effect size increases in core body temperature (as high as 0.4 °C). The low temperature of the dialysate during the CD and the CD + E protocols prevented the rise in S and core temperature (p > 0.05), even during the period that IET took place. Conclusions: TD and IET are accompanied by a moderate level of hyperthermia, which can be offset by CD. We recommended that CD or with IET can prevent the excessive rise of S. Trial registration: Clinical Trial Registry number: NCT03905551 (clinicaltrials.gov), DOR: 05/04/2019, Keywords: Cold dialysis, Body temperature during dialysis, Dialysis temperature, Thermal balance
* Correspondence: [email protected] 2 School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala 42100, Greece 5 School of Sports and Health Sciences, Cardiff Metropolitan University, Cardiff, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this
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