D-Fact

Ever wonder why dialysis patients are so cold?  Temperature always a degree lower then is what many consider normal?

All dialysis patients have levels of uremia (quiet literally translates to “urine in the blood”) in their systems.  The uremia effects the hypothalamus which regulates your body temperature, thus making them run colder then most people causing discomfort and irritation while on the dialysis machine.

Uremia can also drive you a little crazy, quite literally.  If the toxins are allowed to build up causing mental slowness and also in the severist of forms, a few hallucinations.

 

 

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~ by Kim on June 18, 2008.

8 Responses to “D-Fact”

  1. This is why I have a stack of bath blankets on the back of the cot whenever I go to do a dialysis transfer. I knew they ran cold, I never knew why 🙂

  2. That’s quite an impressive uremic frost that person has going on there….

  3. Epi-yeah, every christmas, the corporate gift is fleece blankies and most the time the patients bring two or three, I hear “it’s freezing” about twenty times a day.

    Jeff-yep, that is bad, actually I was told yesterday by a patient who once lives in Alaska that the clinic was colder then the Yukon in the dead of winter, now I think he was exaggerating but I wasn’t going to argue.

  4. We had one pt we thought was just cold all the time anyway. It would be 100 outside when we took her to dialysis and she was dressed head to toe in fleece – hats, gloves, extra socks.

    Thanks for letting us know why.

  5. I didn’t know that it was specifically uremia that caused the feeling of cold; thanks for the explanation.

    When I was on dialysis, one of he nurses used to lower our machine temp to something like 95.5 to keep us from getting hypotensive. I’d rather hypotensive….

  6. I’d need to see the citation – urea is not itself toxic and I don’t think it has any know clinical impact.

    Anemia can cause people to feel cold – and most people on dialysis are anemic. People feel even colder when actually dialyzing because their blood is circulating next to dialysate that can be several degrees cooler than normal body temperature.

    Units are kept cold often for the comfort of the workers – if you end up at NKC notice that each station has its own radiant heat panel in the ceiling to offer some added dialyzor comfort without making staff sweat.

  7. Actually of all the units I have worked at, we don’t keep the units cold for the sake of the workers comfort, in fact, I sweat all day long, every day, as does everyone else I work with. The temp is locked at 76 degrees no matter what, we can’t change it without a passcode, in the scrubs, and labcoats believe me we want to.

    Fresenius K machines and almost every dialysis machine I have worked with warms the dialysate up to 37 degrees celcius which is 98.6 degrees fehrenheit, normal body temp.

    Anemia does cause people to feel cold due to lack of circulation, but uremia is known to effect parts of the brain, thus making it difficult to maintain the normal body temp.

    Links that talk about clinical abnormalities with Uremia:
    http://kidneydiseases.about.com/od/symptomsof/a/uremia.htm
    http://www.emedicine.com/MED/topic2341.htm

    I will ask our nephrologist about the info he gave us about uremia effecting the hypothalamus and provide that for you.

  8. Ah I see. You’re talking about the syndrome, the umbrella term for the symptoms that come with CKD 5, symptoms that include anemia. There isn’t a uremia measure – a uremia level – I read your post as saying urea levels correlate to feeling cold. Uremia.

    Could being under dialyzed effect your hypothalamus? I suppose, but a big part of uremia is anemia – and the sensation of always being cold does, in my experience, go away when the ‘crit is normal. It would be interesting to see the study you heard presented.

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