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

  • Nephrology - Original Paper
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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.

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Acknowledgments

We sincerely appreciated the help of Zsuzsa Gönczi, R.N. during the data collection phase of the study.

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Authors and Affiliations

  1. Fresenius Medical Care, Semmelweis University, Budapest, Hungary

    Mihály B. Tapolyai, Mária Faludi & Klára Berta

  2. Department of Mathematics, Louisiana State University Shreveport, Shreveport, LA, USA

    Tibor Szarvas & Zsolt Lengvárszky

  3. Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

    Miklos Z. Molnar

  4. Medical Service, Overton Brooks Veterans’ Administration Medical Center, Shreveport, LA, USA

    Neville R. Dossabhoy

  5. Department of Internal Medicine, Louisiana State University Health School of Medicine, Shreveport, LA, USA

    Neville R. Dossabhoy

  6. Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, L 504, Jackson, MS, 39216-4505, USA

    Tibor Fülöp

Authors
  1. Mihály B. Tapolyai
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  2. Mária Faludi
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  4. Tibor Szarvas
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  7. Neville R. Dossabhoy
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Corresponding author

Correspondence to Tibor Fülöp.

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Conflict of interest

Drs. Tapolyai and Faludi are employees of Fresenius Medical Care, Hungary. Dr. Berta is a former employee of Fresenius Medical Care, Hungary. All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study was formally reviewed and approved by the Hungarian Ministry of Health, Independent Review Board (TUKEB ad.3034-1/2015 EKU/Hungary). A waiver of written informed consent was granted by TUKEB Independent Review Board.

Human and animal rights statement

This article does not contain any studies with animals performed by any of the authors.

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Tapolyai, M.B., Faludi, M., Berta, K. et al. The effect of ambient temperature and humidity on interdialytic weight gains in end-stage renal disease patients on maintenance hemodialysis. Int Urol Nephrol 48, 1171–1176 (2016). https://doi.org/10.1007/s11255-016-1297-9

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