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Erschienen in: International Urology and Nephrology 7/2016

28.04.2016 | Nephrology - Original Paper

The effect of ambient temperature and humidity on interdialytic weight gains in end-stage renal disease patients on maintenance hemodialysis

verfasst von: Mihály B. Tapolyai, Mária Faludi, Klára Berta, Tibor Szarvas, Zsolt Lengvárszky, Miklos Z. Molnar, Neville R. Dossabhoy, Tibor Fülöp

Erschienen in: International Urology and Nephrology | Ausgabe 7/2016

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Abstract

Purpose

Interdialytic weight gain (IDWG) is both a measure of dietary compliance and a well-established predictor of future adverse outcomes in dialysis patients. The impact of environmental conditions on IDWG in end-stage renal disease is little studied to date.

Methods

We retrospectively reviewed IDWG for 100 consenting chronic end-stage renal disease patients undergoing thrice weekly in-center hemodiafiltration under three different climatic conditions in a Central European city: Weekend_1 was humid (93 %) and warm (24 °C); Weekend_2 was dry (38 %) and hot (33 °C); and Weekend_3 was dry (30 %) and warm (24 °C).

Results

The cohort’s mean age was 60.9 ± 14.7 years, all were Eastern European, and 56 % were men. Residual urine output measured 100 [25–75 % quartiles: 0, 612] mL/day, single-pool Kt/V 1.4 ± 0.25, and albumin 40.1 ± 3.9 g/L. Mean IDWGs measured as follows: Weekend_1 (“humid-warm”): 2973 ± 1386 mL; Weekend_2 (“dry-hot”): 2685 ± 1368 mL and Weekend_3 (“dry-warm”): 2926 ± 1311 mL. Paired-samples testing for difference showed higher fluid gains on the humid-warm (239 mL; 95 % CI 21–458 mL; p = 0.032) and on the dry-warm weekends (222 mL; 95 % CI −8 to 453 mL, p = 0.059), when compared to the dry-hot weekend. Under the latter, dry-hot climatic condition, residual urine output lost its significance to impact IDWG during multiple regression analysis.

Conclusion

While excess temperature may impact IDWG to a small degree, air humidity does not; the least weight gains occurred on the dry-hot weekend. However, the effects of both were minimal under continental summer conditions and are unlikely to explain large excesses of individual session-to-session variations.
Literatur
1.
Zurück zum Zitat Machek P, Jirka T, Moissl U, Chamney P, Wabel P (2010) Guided optimization of fluid status in haemodialysis patients. Nephrol Dial Transplant 25(2):538–544CrossRefPubMed Machek P, Jirka T, Moissl U, Chamney P, Wabel P (2010) Guided optimization of fluid status in haemodialysis patients. Nephrol Dial Transplant 25(2):538–544CrossRefPubMed
2.
Zurück zum Zitat Tapolyai M, Faludi M, Réti V, Lengvárszky Z, Szarvas T, Fülöp T et al (2013) Volume estimation in dialysis patients: the concordance of brain-type natriuretic peptide measurements and bioimpedance values. Hemodial Int 17(3):406–412CrossRefPubMed Tapolyai M, Faludi M, Réti V, Lengvárszky Z, Szarvas T, Fülöp T et al (2013) Volume estimation in dialysis patients: the concordance of brain-type natriuretic peptide measurements and bioimpedance values. Hemodial Int 17(3):406–412CrossRefPubMed
3.
Zurück zum Zitat Tapolyai MB, Faludi M, Fülöp T, Dossabhoy NR, Szombathelyi A, Berta K (2014) Which fluid space is affected by ultrafiltration during hemodiafiltration? Hemodial Int 18(2):384–390CrossRefPubMed Tapolyai MB, Faludi M, Fülöp T, Dossabhoy NR, Szombathelyi A, Berta K (2014) Which fluid space is affected by ultrafiltration during hemodiafiltration? Hemodial Int 18(2):384–390CrossRefPubMed
4.
Zurück zum Zitat Tapolyai M, Faludi M, Réti V, Lengvárszky Z, Szarvas T, Berta K (2011) Dialysis patients’ fluid overload, antihypertensive medications, and obesity. ASAIO J 57(6):511–515CrossRefPubMed Tapolyai M, Faludi M, Réti V, Lengvárszky Z, Szarvas T, Berta K (2011) Dialysis patients’ fluid overload, antihypertensive medications, and obesity. ASAIO J 57(6):511–515CrossRefPubMed
5.
Zurück zum Zitat Voroneanu L, Cusai C, Hogas S, Ardeleanu S, Onofriescu M, Nistor I et al (2010) The relationship between chronic volume overload and elevated blood pressure in hemodialysis patients: use of bioimpedance provides a different perspective from echocardiography and biomarker methodologies. Int Urol Nephrol 42(3):789–797CrossRefPubMed Voroneanu L, Cusai C, Hogas S, Ardeleanu S, Onofriescu M, Nistor I et al (2010) The relationship between chronic volume overload and elevated blood pressure in hemodialysis patients: use of bioimpedance provides a different perspective from echocardiography and biomarker methodologies. Int Urol Nephrol 42(3):789–797CrossRefPubMed
6.
Zurück zum Zitat Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C et al (2009) The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant 24(5):1574–1579CrossRefPubMedPubMedCentral Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C et al (2009) The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant 24(5):1574–1579CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Tsai Y-C, Chiu Y-W, Tsai J-C, Kuo H-T, Hung C-C, Hwang S-J et al (2015) Association of fluid overload with cardiovascular morbidity and all-cause mortality in stages 4 and 5 CKD. Clin J Am Soc Nephrol 10(1):39–46CrossRefPubMed Tsai Y-C, Chiu Y-W, Tsai J-C, Kuo H-T, Hung C-C, Hwang S-J et al (2015) Association of fluid overload with cardiovascular morbidity and all-cause mortality in stages 4 and 5 CKD. Clin J Am Soc Nephrol 10(1):39–46CrossRefPubMed
8.
Zurück zum Zitat Kalantar-Zadeh K, Regidor DL, Kovesdy CP, Van Wyck D, Bunnapradist S, Horwich TB et al (2009) Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation 119(5):671–679CrossRefPubMedPubMedCentral Kalantar-Zadeh K, Regidor DL, Kovesdy CP, Van Wyck D, Bunnapradist S, Horwich TB et al (2009) Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation 119(5):671–679CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Chen KH, Hung CC, Lin-Tan DT, Huang WH, Hsu CW, Weng SM et al (2011) Cardiothoracic ratio association with mortality in patients on maintenance peritoneal dialysis. Ther Apheresis Dial 15(1):81–88CrossRef Chen KH, Hung CC, Lin-Tan DT, Huang WH, Hsu CW, Weng SM et al (2011) Cardiothoracic ratio association with mortality in patients on maintenance peritoneal dialysis. Ther Apheresis Dial 15(1):81–88CrossRef
10.
Zurück zum Zitat Fülöp T, Pathak MB, Schmidt DW, Lengvarszky Z, Juncos JP, Lebrun CJ et al (2010) Volume-related weight gain and subsequent mortality in acute renal failure patients treated with continuous renal replacement therapy. ASAIO J 56(4):333PubMedPubMedCentral Fülöp T, Pathak MB, Schmidt DW, Lengvarszky Z, Juncos JP, Lebrun CJ et al (2010) Volume-related weight gain and subsequent mortality in acute renal failure patients treated with continuous renal replacement therapy. ASAIO J 56(4):333PubMedPubMedCentral
11.
Zurück zum Zitat Losito A, Del Vecchio L, Lusenti T, Del Rosso G, Malandra R, Sturani A (2013) Systolic blood pressure and mortality in chronic hemodialysis patients: results of a nationwide Italian study. J Clin Hypertens 15(5):328–332CrossRef Losito A, Del Vecchio L, Lusenti T, Del Rosso G, Malandra R, Sturani A (2013) Systolic blood pressure and mortality in chronic hemodialysis patients: results of a nationwide Italian study. J Clin Hypertens 15(5):328–332CrossRef
12.
Zurück zum Zitat Covic A, Goldsmith D, Donciu MD, Siriopol D, Popa R, Kanbay M et al (2015) From profusion to confusion: the saga of managing hypertension in chronic kidney disease! J Clin Hypertens 17(6):421–427CrossRef Covic A, Goldsmith D, Donciu MD, Siriopol D, Popa R, Kanbay M et al (2015) From profusion to confusion: the saga of managing hypertension in chronic kidney disease! J Clin Hypertens 17(6):421–427CrossRef
13.
Zurück zum Zitat Tapolyai M, Fülöp T, Uysal A, Lengvárszky Z, Szarvas T, Ballard K et al (2010) Regional differences in nonadherence to dialysis among southern dialysis patients: a comparative cross-sectional study to the dialysis outcomes and practice patterns study. Am J Med Sci 339(6):516–518CrossRefPubMed Tapolyai M, Fülöp T, Uysal A, Lengvárszky Z, Szarvas T, Ballard K et al (2010) Regional differences in nonadherence to dialysis among southern dialysis patients: a comparative cross-sectional study to the dialysis outcomes and practice patterns study. Am J Med Sci 339(6):516–518CrossRefPubMed
14.
Zurück zum Zitat Obialo C, Zager PG, Myers OB, Hunt WC (2014) Relationships of clinic size, geographic region, and race/ethnicity to the frequency of missed/shortened dialysis treatments. J Nephrol 27(4):425–430CrossRefPubMed Obialo C, Zager PG, Myers OB, Hunt WC (2014) Relationships of clinic size, geographic region, and race/ethnicity to the frequency of missed/shortened dialysis treatments. J Nephrol 27(4):425–430CrossRefPubMed
15.
Zurück zum Zitat Saran R, Bragg-Gresham JL, Rayner HC, Goodkin DA, Keen ML, Van Dijk PC et al (2003) Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int 64(1):254–262CrossRefPubMed Saran R, Bragg-Gresham JL, Rayner HC, Goodkin DA, Keen ML, Van Dijk PC et al (2003) Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int 64(1):254–262CrossRefPubMed
16.
Zurück zum Zitat Mollaoğlu M, Kayataş M (2015) Disability is associated with nonadherence to diet and fluid restrictions in end-stage renal disease patients undergoing maintenance hemodialysis. Int Urol Nephrol 47(11):1863–1870CrossRefPubMed Mollaoğlu M, Kayataş M (2015) Disability is associated with nonadherence to diet and fluid restrictions in end-stage renal disease patients undergoing maintenance hemodialysis. Int Urol Nephrol 47(11):1863–1870CrossRefPubMed
17.
Zurück zum Zitat Figaro MK, Mack GW (1997) Regulation of fluid intake in dehydrated humans: role of oropharyngeal stimulation. Am J Physiol-Regul Integr Comp Physiol 272(6):R1740–R1746 Figaro MK, Mack GW (1997) Regulation of fluid intake in dehydrated humans: role of oropharyngeal stimulation. Am J Physiol-Regul Integr Comp Physiol 272(6):R1740–R1746
18.
Zurück zum Zitat Boulze D, Montastruc P, Cabanac M (1983) Water intake, pleasure and water temperature in humans. Physiol Behav 30(1):97–102CrossRefPubMed Boulze D, Montastruc P, Cabanac M (1983) Water intake, pleasure and water temperature in humans. Physiol Behav 30(1):97–102CrossRefPubMed
19.
Zurück zum Zitat Bruzda-Zwiech A, Szczepańska J, Zwiech R (2014) Sodium gradient, xerostomia, thirst and inter-dialytic excessive weight gain: a possible relationship with hyposalivation in patients on maintenance hemodialysis. Int Urol Nephrol 46(7):1411–1417CrossRefPubMed Bruzda-Zwiech A, Szczepańska J, Zwiech R (2014) Sodium gradient, xerostomia, thirst and inter-dialytic excessive weight gain: a possible relationship with hyposalivation in patients on maintenance hemodialysis. Int Urol Nephrol 46(7):1411–1417CrossRefPubMed
21.
Zurück zum Zitat Agarwal R, Weir MR (2010) Dry - weight : a concept revisited in an effort to avoid medication—directed approaches for blood pressure control in hemodialysis patients. J Am Soc Nephrol 5(7):1255–1260CrossRef Agarwal R, Weir MR (2010) Dry - weight : a concept revisited in an effort to avoid medication—directed approaches for blood pressure control in hemodialysis patients. J Am Soc Nephrol 5(7):1255–1260CrossRef
22.
Zurück zum Zitat Spósito M, Nieto FJ, Ventura JE (2000) Seasonal variations of blood pressure and overhydration in patients on chronic hemodialysis. Am J Kidney Dis 35(5):812–818CrossRefPubMed Spósito M, Nieto FJ, Ventura JE (2000) Seasonal variations of blood pressure and overhydration in patients on chronic hemodialysis. Am J Kidney Dis 35(5):812–818CrossRefPubMed
23.
Zurück zum Zitat Hwang J-C, Wang C-T, Chien C-C (2006) Effect of climatic temperature on fluid gain in hemodialysis patients with different degrees of overhydration. Blood Purif 25(5–6):473–479 Hwang J-C, Wang C-T, Chien C-C (2006) Effect of climatic temperature on fluid gain in hemodialysis patients with different degrees of overhydration. Blood Purif 25(5–6):473–479
24.
Zurück zum Zitat Chung S, Kahng KW, Hong TW, Lee CH, Kang CM, Park CH (2003) Seasonal variation of interdialytic weight gain in korean hemodialysis patients. Korean J Nephrol 22(4):426–432 Chung S, Kahng KW, Hong TW, Lee CH, Kang CM, Park CH (2003) Seasonal variation of interdialytic weight gain in korean hemodialysis patients. Korean J Nephrol 22(4):426–432
25.
Zurück zum Zitat Pruijm M, El-Housseini Y, Mahfoudh H, Jarraya F, Hachicha J, Teta D et al (2013) Stimulated sweating as a therapy to reduce interdialytic weight gain and improve potassium balance in chronic hemodialysis patients: a pilot study. Hemodial Int 17(2):240–248CrossRefPubMed Pruijm M, El-Housseini Y, Mahfoudh H, Jarraya F, Hachicha J, Teta D et al (2013) Stimulated sweating as a therapy to reduce interdialytic weight gain and improve potassium balance in chronic hemodialysis patients: a pilot study. Hemodial Int 17(2):240–248CrossRefPubMed
26.
Zurück zum Zitat Argiles A, Mourad G, Mion C (1998) Seasonal changes in blood pressure in patients with end-stage renal disease treated with hemodialysis. N Engl J Med 339(19):1364–1370CrossRefPubMed Argiles A, Mourad G, Mion C (1998) Seasonal changes in blood pressure in patients with end-stage renal disease treated with hemodialysis. N Engl J Med 339(19):1364–1370CrossRefPubMed
27.
Zurück zum Zitat Fine A (2000) Lack of seasonal variation in blood pressure in patients on hemodialysis in a North American center. Am J Kidney Dis 36(3):562–565CrossRefPubMed Fine A (2000) Lack of seasonal variation in blood pressure in patients on hemodialysis in a North American center. Am J Kidney Dis 36(3):562–565CrossRefPubMed
28.
Zurück zum Zitat Cheung AK, Yan G, Greene T, Daugirdas JT, Dwyer JT, Levin NW et al (2002) Seasonal variations in clinical and laboratory variables among chronic hemodialysis patients. J Am Soc Nephrol 13(9):2345–2352CrossRefPubMed Cheung AK, Yan G, Greene T, Daugirdas JT, Dwyer JT, Levin NW et al (2002) Seasonal variations in clinical and laboratory variables among chronic hemodialysis patients. J Am Soc Nephrol 13(9):2345–2352CrossRefPubMed
30.
Zurück zum Zitat Brown IJ, Tzoulaki I, Candeias V, Elliott P (2009) Salt intakes around the world: implications for public health. Int J Epidemiol 38(3):791–813CrossRefPubMed Brown IJ, Tzoulaki I, Candeias V, Elliott P (2009) Salt intakes around the world: implications for public health. Int J Epidemiol 38(3):791–813CrossRefPubMed
31.
Zurück zum Zitat Gutiérrez OM (2013) Sodium-and phosphorus-based food additives: persistent but surmountable hurdles in the management of nutrition in chronic kidney disease. Adv Chronic Kidney Dis 20(2):150–156CrossRefPubMedPubMedCentral Gutiérrez OM (2013) Sodium-and phosphorus-based food additives: persistent but surmountable hurdles in the management of nutrition in chronic kidney disease. Adv Chronic Kidney Dis 20(2):150–156CrossRefPubMedPubMedCentral
Metadaten
Titel
The effect of ambient temperature and humidity on interdialytic weight gains in end-stage renal disease patients on maintenance hemodialysis
verfasst von
Mihály B. Tapolyai
Mária Faludi
Klára Berta
Tibor Szarvas
Zsolt Lengvárszky
Miklos Z. Molnar
Neville R. Dossabhoy
Tibor Fülöp
Publikationsdatum
28.04.2016
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 7/2016
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-016-1297-9

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