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. 2023 Jun 7;24(1):161.
doi: 10.1186/s12882-023-03225-y.

Body temperature and infection in critically ill patients on continuous kidney replacement therapy

Douglas W Challener  1 , Xiaolan Gao  2 , Shahrzad Tehranian  2 , Kianoush B Kashani  2   3 , John C O'Horo  4   3
Affiliations

Body temperature and infection in critically ill patients on continuous kidney replacement therapy

Douglas W Challener et al. BMC Nephrol. .

Abstract

Purpose: Continuous kidney replacement therapy (CKRT) is an increasingly common intervention for critically ill patients with kidney failure. Because CKRT affects body temperature, detecting infections in patients on CKRT is challenging. Understanding the relation between CKRT and body temperature may facilitate earlier detection of infection.

Methods: We retrospectively reviewed adult patients (≥ 18 years) admitted to the intensive care unit at Mayo Clinic in Rochester, Minnesota, from December 1, 2006, through November 31, 2015, who required CKRT. We summarized central body temperatures for these patients according to the presence or absence of infection.

Results: We identified 587 patients who underwent CKRT during the study period, of whom 365 had infections, and 222 did not have infections. We observed no statistically significant differences in minimum (P = .70), maximum (P = .22), or mean (P = .55) central body temperature for patients on CKRT with infection vs. those without infection. While not on CKRT (before CKRT initiation and after cessation), all three body temperature measurements were significantly higher in patients with infection than in those without infection (all P < .02).

Conclusion: Body temperature is insufficient to indicate an infection in critically ill patients on CKRT. Clinicians should remain watchful for other signs, symptoms, and indications of infection in patients on CKRT because of expected high infection rates.

Keywords: Dialysis; Fever; Hypothermia; Sepsis; Thermoregulation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Central Body Temperature Measurement in Patients on Continuous Kidney Replacement Theraphy (CKRT) in the Intensive Care Unit. Mean body temperature measurements recorded 24 h before initiation of CRKT (off CKRT) and 48 h after initiation (on CKRT) were plotted only for patients who had measurements documented during this time period. Solid lines indicate mean temperature, and shaded regions indicate 95% CI
See this image and copyright information in PMC

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