title: Association between cold dialysis and cardiovascular survival in hemodialysis patients.
abstract: BACKGROUND
  Higher cardiovascular mortality has been noted in patients with chronic kidney disease (CKD). CKD patients are also known to have impaired energy expenditure but the role of energy expenditure in cardiovascular disease is not yet known. Furthermore, the association between cold dialysis (CD) and clinical outcomes in hemodialysis patients is unclear.
  
  
  METHODS
  This was a single-center retrospective cohort study consisting of two groups: a CD group with dialyzate temperature <35.5 °C and a standard dialysis (SD) group with dialyzate temperature between 35.5 and 37 °C. The end points of the study were overall mortality, cardiac mortality and non-cardiac mortality. The study analyzed the associations between dialyzate temperature and long-term survival in CD and SD groups. Propensity score analysis was used to control for intergroup baseline differences.
  
  
  RESULTS
  Baseline characteristics of both groups were similar. Kaplan-Meier analysis showed that CD was significantly associated with a lower risk for overall mortality (P = 0.006) and cardiac mortality (P = 0.023) but not for non-cardiac mortality or infectious mortality. After multivariate Cox regression analysis, adjusting for propensity scores and other possible confounding factors, CD remained a significant beneficial factor for overall mortality (P = 0.030) and cardiac mortality (P = 0.034).
  
  
  CONCLUSIONS
  Our studies show that CD is significantly and independently associated with a lower risk for overall mortality and cardiac mortality.
authors: Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors: Heng-Jung
authors: HJ
authors: Hsu
authors: Chiung-Hui
authors: CH
authors: Yen
authors: Kuang-Hung
authors: KH
authors: Hsu
authors: Chin-Chan
authors: CC
authors: Lee
authors: Shu-Ju
authors: SJ
authors: Chang
authors: I-Wen
authors: IW
authors: Wu
authors: Chiao-Yin
authors: CY
authors: Sun
authors: Chia-Chi
authors: CC
authors: Chou
authors: Chen-Chao
authors: CC
authors: Yu
authors: Ming-Fang
authors: MF
authors: Hsieh
authors: Chun-Yu
authors: CY
authors: Chen
authors: Chiao-Ying
authors: CY
authors: Hsu
authors: Cheng-Hao
authors: CH
authors: Weng
authors: Chi-Jen
authors: CJ
authors: Tsai
authors: Mai-Szu
authors: MS
authors: Wu
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D003080:Cold Temperature; D015314:Dialysis Solutions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D015314:Dialysis Solutions