t291268b wondering if anyone has any experience w patients on peritoneal dialysis wanting to use sauna. please advise.

Dori_Schatell
Moderator
Sep '17
I looked in PubMed to see if there were any peer-reviewed studies on this topic, and there were not. In PRE-dialysis, it may be possible to reduce water and toxins in the body by sweating–through saunas, exercise, traditional sweat lodges, etc. But, on PD there may be a risk of infection if you sweat around your catheter exit site. I have asked an expert nurse and will see what I can find out for you.

t291268b
Sep '17
thanks Dori. when I have informed patients in the past that it is not recommended they have been satisfied with that answer. so since I have a patient making request, I am now chasing an answer. I’m thinking it won’t be recommended, as you say, if you sweat there is risk of infection. I’m also thinking it will lower patients BP so if it is low they will just feel worse anyway. I will await your answer. regards, Tania

Dori_Schatell
Moderator
Sep '17
The nurse I asked agreed that this is not a good idea, because of the high heat, which bacteria love–essentially the same reason why hot tubs are also unwise for people on PD.

Background: Dry heat, immersive, and Hammam sauna baths have been shown to aid fluid removal in haemodialysis patients but require high ambient temperatures, large volumes of water and sufficient space, all of which limit their widespread use in India. We aimed to study the safety and efficacy of a commercially available, inexpensive, portable steam sauna bath for this purpose. Methods: In this pilot phase II clinical trial, six adult prevalent haemodialysis patients each underwent 6 sauna sessions lasting 30-60 minutes, on all non-dialysis days, for 2 weeks. Weight, blood pressure, serum urea, creatinine, electrolytes, haematocrit, core body temperature, thermal comfort, and thirst visual analogue scale were measured before and after each session. Karnofsky performance status (KPS) and Dialysis Symptoms Index (DSI) were measured at the beginning and end of the intervention period. The primary end points were per session weight loss and interdialytic weight gain (IDWG). Results: Patients experienced a median weight loss of 0.35 kg, median fall in systolic and diastolic BP of 10 mm Hg and 2 mm Hg respectively (p < 0.001 for all) without significant change in IDWG (p = 0.46). Mean thermal comfort was 5.41 ± 0.56 out of 8, there was no significant increase in thirst (p = 0.06) and no significant change in KPS and DSI scores (p = 1.00 and 0.32 respectively). No adverse events were noted. Conclusions: The portable steam sauna is safe, but modestly effective for fluid removal in haemodialysis patients, and may not influence IDWG.