An analysis of thermal regulation in hemodialysis with one and three compartment models.

A one compartment model of heat kinetics in hemodialysis (HD) was formulated, solved for the body surface heat transfer coefficient, and used to analyze reported clinical data. The analysis showed a linear relationship between percent change in body surface (y) and fractional dialyzer (x) heat loss, such that y = -25 - 44X, p less than 0.001. Thus, when X = 0, surface heat loss decreases 25% and core temperature (T) rises, and X must equal 45% of heat production to stabilize core T during HD. A three compartment model predicts that skin clothing insulation will have to increase 2.5 times to avoid thermal discomfort when X = 45% of heat production. A theoretic mechanism for decreased symptomatic hypotension resulting from stabilization of core T is proposed.