Relation between trends in body temperature and outcome in incident hemodialysis patients.

BACKGROUND: Various biochemical and physiological variables are related to outcome in hemodialysis (HD) patients. However, the prognostic implications of trends in body temperature (BT) in this population have not yet been studied. The aim of this study was to assess the relationship between trends in BT and outcome in incident HD patients.METHODS: Six thousand seven hundred and forty-two incident HD patients without thyroid disease from the Renal Research Institute were followed for 1 year. Patients were divided into tertiles of initial pre-dialysis BT (Tertile 1: </=36.47 degrees C, Tertile 2: >36.47 to 36.71 degrees C and Tertile 3: >36.7 degrees C) and further classified according to the change in BT (increased: >0.01 degrees C/month, decreased: less than -0.01 degrees C/month and stable, with change between -0.01 and +0.01 degrees C/month) during the first year of treatment. The reference group is Tertile 2 of initial temperature with stable BT. Cox regression was used for survival analyses. Analyses were repeated for patients who survived the first year and were treated for >/=1 month in Year 2.RESULTS: BT decreased in 2903 patients, remained stable in 2238 patients and increased in 1601 patients. After adjustment for multiple risk factors, hazard ratios (HRs) for mortality were higher for those groups in whom, irrespective of the initial BT, BT increased or declined, as compared to the reference group during follow-up (HR between 1.46 and 2.27).CONCLUSIONS: The best survival was observed in the group with the highest BT at baseline and stable BT during the follow-up period (HR 0.50).