Thirst in the elderly with and without heart failure

Waldréus, Nana; Sjöstrand, Fredrik; Hahn, Robert G.

doi:10.1016/j.archger.2010.10.003

Cited by 48 publications

(86 citation statements)

References 22 publications

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“…Angiotensin II, when injected into sensitive areas of the brain (40,41) or when injected systemically, is a powerful stimulus for water intake, as is activation of the renin-angiotensin axis (42), providing a mechanistic explanation for the association of thirst with abnormalities of body fluid volume. Thirst is a common complaint for patients with congestive heart failure (43,44), frequently plagues dialysis patients, and likely contributes to the prevalence of hyponatremia in these populations. Pharmacologic blockade of the renin-angiotensin axis, although theoretically attractive, does not seem to reduce thirst (45).…”

Section: Thirstmentioning

confidence: 99%

Osmotic Homeostasis

Danziger

Zeidel

2015

Clinical Journal of the American Society of Nephrology

164

103

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Alterations in water homeostasis can disturb cell size and function. Although most cells can internally regulate cell volume in response to osmolar stress, neurons are particularly at risk given a combination of complex cell function and space restriction within the calvarium. Thus, regulating water balance is fundamental to survival. Through specialized neuronal "osmoreceptors" that sense changes in plasma osmolality, vasopressin release and thirst are titrated in order to achieve water balance. Fine-tuning of water absorption occurs along the collecting duct, and depends on unique structural modifications of renal tubular epithelium that confer a wide range of water permeability. In this article, we review the mechanisms that ensure water homeostasis as well as the fundamentals of disorders of water balance.

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Section: Thirstmentioning

confidence: 99%

Osmotic Homeostasis

Danziger

Zeidel

2015

Clinical Journal of the American Society of Nephrology

164

103

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“…7 For this sub-study, we included patients who completed the questionnaire on compliance with fluid restriction on at least 3 out of 4 followup occasions. When patients had 1 missing value regarding measurement of compliance with fluid restriction, this was substituted by the most frequently reported answer for having thirst (yes or no) on the 4 follow-up occasions.…”

Section: Assessment Of Thirstmentioning

confidence: 99%

“…6 In patients with HF, thirst intensity was graded as 23-75 mm on a visual analogue scale (100 mm), and patients with worsening HF graded the thirst to be of relatively higher intensity. 5,7 Forty-six percent of patients with HF described thirst as troublesome 8 and could not find anything that helped to reduce their thirst for more than a short period of time. 9 Persistent thirst can affect the patient´s ability to manage daily activities, including self-care…”

Section: Introductionmentioning

confidence: 99%

Thirst Trajectory and Factors Associated With Persistent Thirst in Patients With Heart Failure

Waldréus

Wal

Hahn

et al. 2014

Journal of Cardiac Failure

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“…The urine collection made at admission to the hospital was tested for color according to a standardized eightgraded scale as described elsewhere [2,9] . Urine colors 1-3 indicate that an otherwise healthy human is well hydrated, 4-5 the existence of moderate volume depletion, and 6-8 severe volume depletion [9] .…”

Section: Urinary Excretionmentioning

confidence: 99%

“…Such knowledge is of value for further studies of thirst in disease, which is apparently changed in, for example, congestive heart failure [2] . Therefore, this study examined combinations of treatments commonly given to modify fluid balance, such as the administration of electrolyte solution and tap water as well as spontaneous and furosemide-induced urinary excretion.…”

Section: Introductionmentioning

confidence: 99%

Effects of tap water, electrolyte solution, and spontaneous and furosemide-stimulated urinary excretion on thirst

Waldréus

Zdolsek

et al. 2012

WJEM

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AIM:To contrast the effects of various modifications of body fluid volumes on thirst as reported by healthy volunteers. METHODS:Ten male volunteers aged between 19 and 37 years (mean 22 years) underwent four experiments each, which comprised infusion of 400-800 mL of acetated Ringer's solution and intake of 600 mL of tap water. Half of the experiments were preceded by volume depletion (median 1.7 L) with furosemide. A visual analogue scale (0-100 mm) was used to assess perceived thirst during each experiment. RESULTS:Volume depletion (P < 0.001) and tap water (P < 0.03) both affected thirst by 13 mm per L of fluid, whereas spontaneous diuresis and infusion of Ringer's acetate did not significantly change the thirst rating (multiple regressions). More detailed analyses showed that the volume depletion increased the median (25th-75th percentiles) thirst rating from 28 mm (21-43) to 59 mm (46-72, P < 0.001) while no change occurred in those who were only slightly thirsty (< 30 mm) before the volume depletion began. Ringer's solution alleviated thirst in those who were very thirsty, but tended to increase thirst in the volunteers who were not thirsty before the infusion. Similarly, hydration with tap water decreased thirst (by 24 mm, P < 0.04) in those who were thirsty (> 60 mm) while the others reported no change. CONCLUSION:The change in thirst rating during volume depletion, administration of Ringer's acetate, and ingestion of tap water were all dependent on the thirst rating obtained when the manipulation of the body fluid volume was initiated.

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Thirst in the elderly with and without heart failure

Cited by 48 publications

References 22 publications

Osmotic Homeostasis

Osmotic Homeostasis

Thirst Trajectory and Factors Associated With Persistent Thirst in Patients With Heart Failure

Effects of tap water, electrolyte solution, and spontaneous and furosemide-stimulated urinary excretion on thirst

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