Modulation of dialysate temperature and its impact on post-dialysis fatigue and thermal comfort: A pre-post interventional study

Abstract

Background: Post-dialysis fatigue is a frequent and burdensome symptom in patients undergoing maintenance hemodialysis. While intradialytic symptoms are commonly monitored in clinical practice, symptoms emerging after dialysis and affecting post-dialysis recovery are often less systematically addressed. This study evaluated the effects of a reduced dialysate temperature on post-dialysis fatigue and thermal comfort. Methods: This single-group pre-post interventional study was conducted between May and June 2025 at a dialysis center. Of the 220 screened patients, 130 met the eligibility criteria after the predefined clinical exclusions. Patients with Post-Dialysis Fatigue Scale scores >= 28 were included in the intervention phase (n = 57). The dialysate temperature was reduced from 36.5 degrees C to 36.0 degrees C for three consecutive sessions. Thermal comfort was assessed using a numerical visual analog scale. Data were analyzed using repeated-measures ANOVA, correlation, and regression analyses. Results: Post-dialysis fatigue significantly decreased after the intervention (F = 25.82,p < 0.001;d(z) = 0.91). Changes in systolic blood pressure independently predicted fatigue improvement (beta = -0.557,p = 0.019). Thermal comfort remained stable during the intervention. Conclusion: Reducing the dialysate temperature may be a feasible approach to alleviate post-dialysis fatigue without compromising thermal comfort.