Stimulated sweating as a therapy to reduce interdialytic weight gain and improve potassium balance in chronic hemodialysis patients: A pilot study

Controlling the extracellular volume in hemodialysis patients is a difficult task. The aim of this study was to evaluate the capacity of different methods of stimulated sweating to reduce mean interdialytic weight gain ( IWG ), to improve blood pressure regulation, and potassium/urea balance. Two center, crossover pilot study. In L ausanne, hemodialysis patients took four hot‐water baths a week, 30 minutes each, on nondialysis days during 1 month. In Sfax, patients visited the local H ammam C enter four times a week. Hemodynamic parameters were recorded, and weekly laboratory analysis was performed. Results were compared with a preceding 1‐month control period. In L ausanne, five patients (all men, median age 55 years) participated. Bathing temperature was (mean ± standard deviation) 41.2 ± 3° C and sweating‐induced weight loss 600 ± 500 g. Mean IWG (control vs. intervention period) decreased from 2.3 ± 0.9 to 1.8 ± 1 kg ( P  = 0.004), Systolic blood pressure from 139 ± 21 to 136 ± 22  mmHg ( P  = 0.4), and diastolic blood pressure form 79 ± 12 to 75 ± 13  mmHg ( P  = 0.08); antihypertensive therapy could be reduced from 2.8 ± 0.4 to 1.9 ± 0.5 antihypertensive drugs per patient ( P  = 0.01). In S fax ( n  = 9, median age 46 years), weight loss per H ammam session was 420 ± 100 g. No differences were found in IWG or BP , but predialysis serum potassium level decreased from 5.9 ± 0.8 to 5.5 ± 0.9 mmol/L ( P  = 0.04) and urea from 26.9 ± 6 to 23.1 ± 6 mmol/L ( P  = 0.02). Hot‐water baths appear to be a safe way to reduce IWG in selected hemodialysis patients. H ammam visits reduce serum potassium and urea levels, but not IWG . More data in larger patient groups are necessary before definite conclusion can be drawn.