Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and thirst

Bots, Casper P.; Brand, H.S.; Veerman, E.C.I.; Valentijn-Benz, Marianne; Amerongen, Barbara M. van; Valentijn, R. M.; Vos, Pieter C.; Bijlsma, Joost A.; Bezemer, P.D.; Wee, Piet M. ter; Amerongen, A. van Nieuw

doi:10.1111/j.1523-1755.2004.00933.x

Cited by 112 publications

(157 citation statements)

References 44 publications

(47 reference statements)

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“…O baixo fluxo salivar nessa população já foi descrito e o mesmo está associado à baixa ingesta hídrica, à polimedicação e ao estado patológico glandular pela uremia, que altera o gradiente de osmolaridade nas glândulas salivares 15,18 . Em 61,5% dos voluntários renais crônicos, o fluxo salivar esteve reduzido e isto é fator propício ao surgimento de cáries 7 .…”

Section: Discussionunclassified

“…Em 61,5% dos voluntários renais crônicos, o fluxo salivar esteve reduzido e isto é fator propício ao surgimento de cáries 7 . Segundo Bots e colaboradores 15 , quanto maior a sensação de boca seca, maior ganho interdialítico, e quanto maior ganho crônico, pior prognóstico cardiovascular.…”

Section: Discussionunclassified

“…Estes processos infecciosos tornam-se mais agressivos na vigência da imunossupressão medicamentosa utilizada no pós-transplante renal 15 .…”

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Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Lacerda

Viana

Dores

et al. 2015

Rev. odontol. UNESP

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ResumoIntroduçãoA doença renal crônica leva a alterações salivares que interferem na saúde bucal. A imunossupressão no pós-transplante pode facilitar que situações restritas à boca se tornem sistêmicas.ObjetivoCaracterizar a saúde bucal de pacientes renais crônicos aptos a transplante, avaliando fluxo e pH salivar, capacidade tamponante salivar (CTS), lesões estomatológicas, sangramento gengival, cálculo e índice de dentes cariados, perdidos e obturados (CPOD).Material e métodoEstudo transversal, observacional e analítico. Foi coletada saliva não estimulada de 83 voluntários, com hipofluxo salivar caracterizado como < 0,3 mL/min. O pH salivar foi mensurado por fita e considerado alcalino quando > 7. A CTS foi avaliada pela Técnica de Ericsson. Um único examinador calibrado procedeu às avaliações clínicas. Foram utilizados Teste Exato de Fisher, ANOVA e Regressão Linear, com nível de significância de 0,05 e Intervalo de Confiança de 95%.ResultadoHipofluxo salivar esteve presente em 61% da amostra e foi influenciado pelo ganho hídrico interdialítico (p=0,01). A presença de pH salivar alcalino foi influenciada pela ureia sérica (p<0,01) e pela hiperfosfatemia (p=0,01). A CTS foi ótima em 92% e sofreu influência do pH salivar (p=0,02). Três indivíduos apresentaram lesões estomatológicas infecciosas. Sangramento gengival esteve presente em 55%, cálculo em 94% e cárie em 88%. O índice CPOD da amostra foi 17,9 ± 7,48.ConclusãoA saúde bucal dos voluntários foi considerada precária e esse agravo pode se tornar mais maléfico se esses indivíduos forem transplantados. Salienta-se a importância da inserção do Dentista na equipe que assiste o renal crônico.

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Section: Discussionunclassified

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Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Lacerda

Viana

Dores

et al. 2015

Rev. odontol. UNESP

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“…We also performed quality-of-life scoring for both types of dialysis using the validated Short Form (SF-36) questionnaire (12) and developed a simple questionnaire to evaluate systematically symptoms of cold (see Appendix). This questionnaire was formulated according to similar scoring tools (13), and the questions that assessed severe symptoms of cold were weighted to score more heavily. The lowest score, signifying no thermal symptoms, was 6, and the highest score, indicating severe symptoms of cold, was 24.…”

Section: Study Protocolmentioning

confidence: 99%

Dialysis-Induced Regional Left Ventricular Dysfunction Is Ameliorated by Cooling the Dialysate

Selby

Burton

Chesterton

et al. 2006

Clinical Journal of the American Society of Nephrology

155

166

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Dialysis patients who develop cardiac failure have a poor prognosis. Recurrent subclinical myocardial ischemia is important in the genesis of heart failure in nondialysis patients. It has previously been demonstrated that subclinical ischemia occurs during hemodialysis; therefore, this study examined whether the improved stability of cool-temperature dialysis lessens this phenomenon. Ten patients who were prone to intradialytic hypotension entered a randomized, crossover study to compare the development of dialysis-induced left ventricular (LV) regional wall motion abnormalities (RWMA) at dialysate temperatures of 37 and 35°C. Serial echocardiography with quantitative analysis was used to assess ejection fraction and regional systolic LV function. BP and hemodynamic variables were measured using continuous pulse wave analysis. The severity of thermal symptoms was scored using a simple questionnaire. Forty-nine new RWMA developed in nine patients during hemodialysis with dialysate at 37°C (HD 37 ), compared with thirteen RWMA that developed in four patients during HD 35 (odds ratio 3.8; 95% confidence interval 2.1 to 6.9). The majority of RWMA displayed improved function by 30 min after dialysis. Overall, regional systolic LV function was significantly more impaired during HD 37 (P < 0.001). BP was higher during HD 35 , with fewer episodes of hypotension as a result of a higher peripheral resistance and no difference in stroke volume. The development of thermal symptoms was heterogeneous, with most patients tolerating HD 35 well. This study confirms previous findings of reversible LV RWMA that develop during hemodialysis. It also shows that this phenomenon can be ameliorated by reducing dialysate temperature, a simple intervention with no cost implications.

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“…24 A study by Bots et al in 2004 found a correlation between interdialytic weight gain and thirst as well as with the total number of medications being used. 25 There was also a correlation between elevated hemoglobin-A1c level and thirst. 26 27 …”

Section: External Factorsmentioning

confidence: 86%

Medication Side Effects: Barriers to the Management of Fluid Intake

Iacono

2008

Dialysis & Transplantation

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Managing fl uid intake can be complicated and stressful for hemodialysis patients. It is known that excessive interdialytic weight gain greatly increases the risk of cardiovascular complications and death. Research has tried to identify individual characteristics and motives to explain why certain patients fail to adhere to their fl uid restrictions. In addition to intrinsic causes, external barriers also may impede compliance. Numerous medications frequently prescribed to the hemodialysis population are known to have negative side effects, such as dry mouth, vomiting, diarrhea, and constipation. Homeostasis can be diffi cult to achieve when a patient has to constantly deal with these symptoms. This article reviews medications commonly used in hemodialysis and the side effects they have that may affect fl uid management.

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Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and thirst

Abstract: In HD patients, xerostomia (XI) and thirst (DTI) are associated with a higher IWG. Our data provide evidence that, in HD patients, xerostomia is related to both salivary flow rate and thirst (DTI).

Cited by 112 publications

References 44 publications

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Dialysis-Induced Regional Left Ventricular Dysfunction Is Ameliorated by Cooling the Dialysate

Medication Side Effects: Barriers to the Management of Fluid Intake

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