{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:28:33Z","timestamp":1791851313534,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intradialytic hypotension (IDH) is a common and clinically significant complication in patients undergoing chronic hemodialysis. The application of low\u2010temperature dialysate has been proposed as a potential intervention to mitigate this condition; however, its effectiveness requires further evaluation through systematic reviews and meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search of articles published up to April 10, 2025, systematically searched electronic databases (PubMed, Embase, CINAHL, and Cochrane Library). Quality assessment was performed using the Cochrane Risk of Bias 2 tool for randomized crossover trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Low dialysate temperature significantly decreases the incidence of IDH (OR\u2009=\u20090.35, 95% CI: [0.28, 0.46],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), increases mean arterial pressure (SMD\u2009=\u20090.67, 95% CI: [0.38, 0.96],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and mean systolic blood pressure (SMD\u2009=\u20090.54, 95% CI: [0.30, 0.79],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, low dialysate temperature improves urea clearance dialysis adequacy (SMD\u2009=\u20090.25, 95% CI: [0.03, 0.47],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and urea reduction rate (SMD\u2009=\u20090.24, 95% CI: [0.02, 0.47],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), while decreasing intradialytic mean body temperature (SMD\u2009=\u2009\u22120.68, 95% CI: [\u22120.99, \u22120.37],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The subgroup analysis revealed that dialysate temperatures between 34.5\u00b0C and 35.0\u00b0C were more effective in improving these related outcomes compared to temperatures ranging from 35.1\u00b0C to 36.0\u00b0C.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maintaining low dialysate temperatures between 34.5\u00b0C and 36.0\u00b0C is recommended to reduce the incidence of IDH and improve dialysis adequacy in chronic hemodialysis patients. The specific low dialysate temperature should be individualized to minimize IDH risk, enhance patient comfort, and optimize treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sdi.70010","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:20:19Z","timestamp":1760919619000},"page":"303-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of Low Dialysate Temperature on Intradialytic Hypotension and Dialysis Adequacy in Chronic Hemodialysis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9008-556X","authenticated-orcid":false,"given":"Ting\u2010Wan","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Nursing Hsinchu Mackay Memorial Hospital  Hsinchu City Taiwan R.O.C"},{"name":"Department of Nursing Yuanpei University of Medical Technology  Hsinchu Taiwan R.O.C"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5352-958X","authenticated-orcid":false,"given":"Han\u2010Ling","family":"Tan","sequence":"additional","affiliation":[{"name":"National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Shu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nursing Hsinchu Mackay Memorial Hospital  Hsinchu City Taiwan R.O.C"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2960-015X","authenticated-orcid":false,"given":"Yu\u2010Chu","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Nursing Yuanpei University of Medical Technology  Hsinchu Taiwan R.O.C"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,19]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","first-page":"493","article-title":"End\u2010Stage Renal Disease: Medical Management","volume":"104","author":"Wouk N.","year":"2021","journal-title":"American Family Physician"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.akdh.2024.06.003"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-022-00542-7"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.01.046"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaa078"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S245621"},{"key":"e_1_2_10_9_1","first-page":"597","article-title":"Effect of Extracorporeal Blood Cooling on Dialytic Arterial Hypotension","volume":"18","author":"Maggiore Q.","year":"1981","journal-title":"Proceedings of the European Dialysis and Transplant Association"},{"issue":"4","key":"e_1_2_10_10_1","first-page":"1","article-title":"The Effect of Dialysate Temperature on Dialysis Adequacy and Hemodynamic Stability: An Experimental Study With Crossover Design","volume":"41","author":"Mathew G. G.","year":"2024","journal-title":"Giornale Italiano di Nefrologia"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.07.015"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.14088"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.13039"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl126"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04580415"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012598.pub2"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_18_1","unstructured":"J. P. T.Higgins J.Thomas J.Chandler et\u00a0al. \u201cCochrane Handbook for Systematic Reviews of Interventions \u201d version 6.4. Cochrane (2023) accessed May 8 2025 https:\/\/www.training.cochrane.org\/handbook."},{"key":"e_1_2_10_19_1","volume-title":"Comprehensive Meta Analysis Version 2.0: Introduction to the Program","author":"Biostat","year":"2006"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6342"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg512"},{"issue":"4","key":"e_1_2_10_23_1","first-page":"596","article-title":"Effect of Dialysate Temperature on Hemodynamic Stability Among Hemodialysis Patients","volume":"20","author":"Azar A. T.","year":"2009","journal-title":"Saudi Journal of Kidney Diseases and Transplantation"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh315"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000076854"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12761"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2009.00355.x"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(99)70427-0"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.0590031175.x"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(96)90310-8"},{"issue":"3","key":"e_1_2_10_31_1","first-page":"378","article-title":"Stabilizing Effects of Cool Dialysate Temperature on Hemodynamic Parameters in Diabetic Patients Undergoing Hemodialysis","volume":"19","author":"Ghasemi A.","year":"2008","journal-title":"Saudi Journal of Kidney Diseases and Transplantation"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000100496"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002480-199407000-00084"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.29887"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1993.287"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V95877"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1992.147"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.34506"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1159\/000184982"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2007.00568.x"},{"issue":"6","key":"e_1_2_10_41_1","first-page":"737","article-title":"How Can We Improve Symptomatic Hypotension in Hemodialysis Patients: Cold Dialysis vs Isothermic Dialysis","volume":"27","author":"Ramos R.","year":"2007","journal-title":"Nefrolog\u00eda"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2022.06.021"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V86956"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(84)80029-3"},{"issue":"4","key":"e_1_2_10_45_1","first-page":"461","article-title":"Temperature Dialysate and Hemodialysis Tolerance","volume":"26","author":"Teruel J. L.","year":"2006","journal-title":"Nefrolog\u00eda"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V1181512"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(99)70149-6"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01800408"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1995.289"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1159\/000141926"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.22.241"}],"container-title":["Seminars in Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.70010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/sdi.70010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.70010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:30:46Z","timestamp":1781494246000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sdi.70010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":50,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/sdi.70010"],"URL":"https:\/\/doi.org\/10.1111\/sdi.70010","archive":["Portico"],"relation":{},"ISSN":["0894-0959","1525-139X"],"issn-type":[{"value":"0894-0959","type":"print"},{"value":"1525-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}