The Effects of Cool Dialysate on Pruritus Status During Hemodialysis of Patients With Chronic Renal Failure: A Controlled Randomized Clinical Trial

Pruritus during dialysis is a common complaint among patients undergoing hemodialysis. Despite progress in medical science and technology in the field of hemodialysis, there is still no cure for pruritus. The aim of this study was to determine the effect of cool dialysate on the severity of pruritus during hemodialysis of patients with chronic renal failure. This study was a two-group, triple-blinded randomized clinical trial, with a parallel design. It consisted of 60 patients with chronic renal failure who were receiving hemodialysis at hemodialysis centers in Mashhad. The patients were divided into two equal groups: 30 patients in an intervention group and 30 patients in a control group. Initially, the patients in both groups underwent dialysis for one week (three sessions) with a standard dialysis solution (temperature of 37 °C). In the next phase, the control group received the standard dialysis solution, whereas the intervention group received a cool dialysis solution (35.5°C) for one week (three sessions). The severity of pruritus was recorded using a visual analogue scale (VAS), with itching scored from 0 - 10 on an hourly basis during the dialysis sessions. Before the intervention, there was no significant between-group difference in the severity of pruritus (P < 0.05). After the intervention, the severity of pruritus was significantly reduced (reduction of 3 points, itching score range of 0 - 10) (P < 0.0001). Dialysis with cool dialysate is a simple and cheap nondrug method, which was readily accepted by the patients. This method could significantly reduce the severity of pruritus in patients during dialysis.