Objective To investigate the present situation and influencing factors of the thirst sensation in maintenance hemodialysis (MHD) patients. Methods A total of 369 MHD patients in the Hemodialysis Center, Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Traditional Chinese Medical University between February to May 2022 were investigated by convenient sampling method. The general information questionnaire, simplified xerostomia inventory and dialysis thirst inventory were used. The saliva secretion volume at baseline without stimulation was measured. Results The average score of dialysis thirst inventory in the 369 MHD patients was 14.80±3.19; 64.5% were mild thirst (10～15 scores), 26.0% were moderate thirst (16～20 scores), and 9.5% were severe thirst (21～25 scores); thirst (dialysis thirst inventory score ≥16) was found in 35.5% of the 369 MHD patients. The average score of simplified xerostomia inventory was 12.46±2.51 in the 369 MHD patients. The baseline and unstimulated saliva secretion volume was 0.21 (0.09, 0.35) ml/min. Logistic regression analysis showed that average ultrafiltration volume (OR=1.001, 95% CI:1.000～1.002, P=0.002), score of simplified xerostomia inventory (OR=3.186, 95% CI: 2.458～4.131, P＜0.001) and degree of salty taste (OR=0.440, 95% CI: 0.209～0.930, P=0.031) were the main influencing factors for thirst in MHD patients. Conclusion Thirst is a common symptom that disturbs MHD patients, and is affected by many factors. Thirst in MHD patients justifies to be concerned by the medical professionals that take care of them. Intervention of thirst based on the clinical conditions of the MHD patients is required.
[1] Yang C, Gao B, Zhao X, 等. Executive summary for china kidney disease network (ck-net) 2016 annual data report[J]. Kidney international, 2020, 98(6): 1419-1423.
[2] Gizowski C, Bourque C W. The neural basis of homeostatic and anticipatory thirst[J]. Nature Reviews. Nephrology, 2018, 14(1): 11-25.
[3] Kara B. Determinants of thirst distress in patients on hemodialysis[J]. Int Urol Nephrol, 2016, 48(9): 1525-1532.
[4] López-Pintor R M, López-Pintor L, Casa?as E, 等. Risk factors associated with xerostomia in haemodialysis patients[J]. Med Oral Patol Oral Cir Bucal, 2017, 22(2): e185-e192.
[5] Rezapour M, Khavanin Zadeh M, Sepehri M M, 等. Less primary fistula failure in hypertensive patients[J]. Journal of human hypertension, 2018, 32(4): 311-318.
[6] 刘威, 刘昊虹, 周兵, 等. 血液透析患者透析间期体重增长与心功能关系研究[J]. 中国医药科学, 2018, 8(12): 182-184+192.
[7] 李阿敏, 赵云飞, 周立恒, 等. 维持性血液透析患者口渴的研究进展[J]. 护士进修杂志, 2020, 35(15): 1408-1412.
[8] 张周沧, 丁云飞, 杜凯强, 等. 袢利尿剂对有残余肾功能的维持性血液透析患者容量负荷影响的初步研究[J]. 中国血液净化, 2021, 20(01): 1-5.
[9] 林果为, 王吉耀, 葛均波. 实用内科学[M].15版.北京:人民卫生出版社,2017：2867.
[10] Bots C P, Brand H S, Veerman E C I, 等. Chewing gum and a saliva substitute alleviate thirst and xerostomia in patients on haemodialysis[J]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2005, 20(3): 578-584.
[11] Thomson W M, van der Putten G-J, de Baat C, 等. Shortening the xerostomia inventory[J]. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 2011, 112(3): 322-327.
[12] Nerbass F B, Morais J G, dos Santos R G, 等. Factors associated to salt intake in chronic hemodialysis patients[J]. J Bras Nefrol, 2013, 35(2): 87-92.
[13] 邵碧云, 孟晓丽, 应金萍, 等. 维持性血液透析患者口渴现状调查及影响因素分析[J]. 护理与康复, 2021, 20(08): 69-72.
[14] 朱亚杰, 辛霞, 高菊林, 等. 陕西省维持性血液透析患者透析现状及症状困扰的调查研究[J]. 中国血液净化, 2021, 20(07): 493-497.
[15] Amirian T, Maddani SZ, Azadbakht M. Yousofpour A Comparative Study on the Views of Persian Medicine and Conventional Medicine about Thirst and its Etiology. [J]. J Mazandaran Univ Med Sci, 2016, 26: 246-257.
[16] Koshy RM, Jamil RT. Physiology, Osmoreceptors[M]. Treasure Island: StatPearls Publishing, 2022: 1-7.
[17] Chang L-Y, Ding Y, Zhang H-M, 等. Re. 'Predictive value of phase angle in sarcopenia in patients on maintenance hemodialysis':" Author's response[J]. Nutrition (Burbank, Los Angeles County, Calif.), 2022, 98: 111634.
[18] 张红梅, 李理, 刘艳婷, 等. 遂宁地区体检健康成人不同血浆渗透压计算公式参考区间的调查[J]. 临床医药实践, 2021, 30(06): 430-433+480.
[19] Armstrong L E, Giersch G E W, Dunn L, 等. Inputs to thirst and drinking during water restriction and rehydration[J]. Nutrients, 2020, 12(9).
[20] Armstrong L E, Kavouras S A. Thirst and drinking paradigms: Evolution from single factor effects to brainwide dynamic networks[J]. Nutrients, 2019, 11(12).
[21] 刘国香, 韩国锋, 王颖. 维持性血液透析患者口渴以及影响因素分析[J]. 中国中西医结合肾病杂志, 2016, 17(12): 1095-1097.
[22] Armstrong L E, Johnson E C. Water intake, water balance, and the elusive daily water requirement[J]. Nutrients, 2018, 10(12).
[23] Postorino M, Catalano C, Martorano C, 等. Salivary and lacrimal secretion is reduced in patients with esrd[J]. Am J Kidney Dis, 2003, 42(4): 722-728.
[24] 李阿敏, 张海林, 尹丽霞, 等. 维持性血液透析患者口腔干燥的现状及影响因素分析[J]. 临床肾脏病杂志, 2019, 19(01): 29-33.
[25] 陈超伦, 苏家增, 俞光岩. 酸刺激对腮腺和下颌下腺唾液流率及成分的影响[J]. 北京大学学报(医学版), 2022, 54(01): 89-94.
[26] López-Pintor R M, López-Pintor L, González-Serrano J, 等. Impact and efficacy of topical dry mouth products in haemodialysis patients with xerostomia: A pilot study[J]. Oral Health & Preventive Dentistry, 2020, 18(1): 1039-1045.
[27] Colson A, Brinkley A, Braconnier P, 等. Impact of salt reduction in meals consumed during hemodialysis sessions on interdialytic weight gain and hemodynamic stability[J]. Hemodialysis international. International Symposium on Home Hemodialysis, 2018, 22(4): 501-506.
[28] Sakai A, Hamada H, Hara K, 等. Nutritional counseling regulates interdialytic weight gain and blood pressure in outpatients receiving maintenance hemodialysis[J]. The Journal of Medical Investigation : JMI, 2017, 64(1.2): 129-135.
