Study on the Clinical Significance and Related Factors of Thirst and Xerostomia in Maintenance Hemodialysis Patients

Fan, Weifeng; Zhang, Qi; Luo, Lihong; Niu, Jianying; Gu, Yan

doi:10.1159/000355717

Cited by 46 publications

(121 citation statements)

References 38 publications

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“…Likewise, some studies have observed the existence of a positive correlation among thirst, xerostomia and IDWG in HD patients (11,14,18,19). These factors could contribute on morbidity and mortality of HD patients.…”

Section: Introductionmentioning

confidence: 85%

“…HD patients have to maintain a correct fluid volume balance, which should be achieved by daily restrictions in fluid consumption. Improper drinking behaviours in HD patients lead to fluid overload, which may give rise to hypertension, pulmonary oedema or other cardiovascular manifestations (11,18). …”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have found an important number of HD patients suffered from thirst, xerostomia and saliva reduction (15,18). Likewise, some studies have observed the existence of a positive correlation among thirst, xerostomia and IDWG in HD patients (11,14,18,19).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors associated with xerostomia in haemodialysis patients

Lopez-Pintor¹,

López-Pintor²,

Casañas³

et al. 2017

Med Oral

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BackgroundTo determine the prevalence of xerostomia and hyposalivation in Haemodialysis (HD) patients, to clarify risk factors, assess patient´s quality of life, and to establish a possible correlation among interdialytic weight gain (IDWG) and xerostomia.Material and MethodsThis study was performed on a group of 50 HD patients. Data were collected using a questionnaire containing demographic and clinical variables, a visual analogue scale (VAS) for xerostomia, IDWG, and an oral health impact profile questionnaire (OHIP-14). Unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected.ResultsA total of 28 HD patients (56%) suffered xerostomia. Dry mouth was associated with hypertension (OR, 5.24; 95% CI, 1.11-24.89) and benzodiazepine consumption (OR, 5.96; 95% CI, 1.05-33.99). The mean xerostomia VAS and OHIP-14 scores were 31.74±14.88 and 24.38±11.98, respectively. No significant correlation was observed between IDWG% and VAS and OHIP total score. Nonetheless, a positive correlation between VAS level of thirst and IDWG% was found (r=0.48 p=0.0001). UWS and SWS means (determined in 30 patients) were 0.16±0.17 and 1.12±0.64, respectively. Decreased values of UWS and SWS were reported in 53.33% and 36.66% of HD patients.ConclusionsXerostomia in HD has a multifactorial aetiology due to accumulative risks as advanced age, systemic disorders, drugs, fluid intake restriction, and salivary parenchymal fibrosis and atrophy. Therefore, it is important to detect possible xerostomia risk factors to treat correctly dry mouth in HD patients and avoid systemic complications. Key words:Haemodialysis patients, xerostomia, salivary flow rate, hyposalivation, interdialytic weight gain, oral health-related quality of life.

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Section: Introductionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors associated with xerostomia in haemodialysis patients

Lopez-Pintor¹,

López-Pintor²,

Casañas³

et al. 2017

Med Oral

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show abstract

“…Additionally, it is conceivable that patients who consume more protein have a higher salt intake resulting in thirst. Thirst is prevalent in dialysis patients and is associated with higher IDWG and lower quality of life [25].…”

Section: Discussionmentioning

confidence: 99%

Causes and Consequences of Interdialytic weight gain

Ipema

Kuipers

Westerhuis

et al. 2016

Kidney Blood Press Res

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Background/Aims: Higher interdialytic weight gain (IDWG) is associated with higher predialysis blood pressure and increased mortality. IDWG is also increasingly being recognized as an indicator of nutritional status. We studied in detail the associations of various patient factors and nutritional parameters with IDWG. Methods: We collected data during one week for IDWG and hemodynamic parameters in 138 prevalent adult haemodialysis patients on a thrice-weekly haemodialysis schedule. A multivariate linear regression analysis was employed to identify factors that are associated with IDWG. Results: The mean (±SD) age was 62.5 (±18.2) years, 36% were female, 36% had diuresis, and 23% had diabetes. Patients in the highest IDWG tertile were significantly younger, more frequently male, and had a significantly higher subjective global assessment score (SGA). A higher IDWG as a percentage of body weight (%IDWG) was associated with a younger age, greater height and weight, absence of diuresis, and lower postdialysis plasma sodium levels. The model with these five parameters explained 37% of the variance of %IDWG. Predialysis, intradialysis, and postdialysis diastolic blood pressure was significantly higher in the highest tertile of IDWG. Conclusion: The most important associations of %IDWG are age, height, weight, diuresis, and postdialysis sodium. Patients with the highest IDWG have significantly higher diastolic blood pressures.

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“…Patients on HD may be particularly vulnerable to such triggers because of thirst augmentation from wide serum-dialysate sodium gradients (21). In fact, increased thirst among patients on HD is associated with increased IDWG and reduced quality of life (22).…”

Section: Discussionmentioning

confidence: 99%

Patient-Stated Preferences Regarding Volume-Related Risk Mitigation Strategies for Hemodialysis

Flythe

Mangione

Brunelli

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Larger weight gain and higher ultrafiltration rates have been associated with poorer outcomes among patients on dialysis. Dietary restrictions reduce fluid-related risk; however, adherence is challenging. Alternative fluid mitigation strategies include treatment time extension, more frequent dialysis, adjunct peritoneal dialysis, and wearable ultrafiltration devices. No data regarding patient preferences for fluid management exist. A survey was designed, tested, and administered to assess patient-stated preferences regarding fluid mitigation.Design, setting, participants, & measurements A written survey concerning fluid-related symptoms, patient and treatment characteristics, and fluid management preferences was developed. The cross-sectional survey was completed by 600 patients on hemodialysis at 18 geographically diverse ambulatory facilities. Comparisons of patient willingness to engage in volume mitigation strategies across fluid symptom burden, dietary restriction experience, and patient characteristics were performed.Results Final analyses included 588 surveys. Overall, if allowed to liberalize fluid intake, 44.6% of patients were willing to extend treatment time by 15 minutes. Willingness to extend treatment time was incrementally less for longer treatment extensions; 12.2% of patients were willing to add a fourth weekly treatment session, and 13.5% of patients were willing to participate in nocturnal dialysis three nights per week. Patients more bothered by their fluid restrictions (versus less bothered) were more willing to engage in fluid mitigation strategies. Demographic characteristics and symptoms, such as cramping and dyspnea, were not consistently associated with willingness to engage in the proposed strategies. More than 25% of patients were unsure of their dry weights and typical interdialytic weight gains.Conclusions Patients were generally averse to treatment time extension.15 minutes. Patients more bothered (versus less bothered) by their prescribed fluid restrictions were more willing to engage in volume mitigation strategies. Additional study of patient-stated preferences in hemodialysis treatment practices is needed to guide patient care and identify deficiencies in patient treatment and disease-related knowledge.

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Study on the Clinical Significance and Related Factors of Thirst and Xerostomia in Maintenance Hemodialysis Patients

Cited by 46 publications

References 38 publications

Risk factors associated with xerostomia in haemodialysis patients

Risk factors associated with xerostomia in haemodialysis patients

Causes and Consequences of Interdialytic weight gain

Patient-Stated Preferences Regarding Volume-Related Risk Mitigation Strategies for Hemodialysis

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