Bots Casper P, Brand Henk S, Veerman Enno C I, Valentijn-Benz Marianne, Van Amerongen Barbara M, Valentijn Robert M, Vos Pieter F, Bijlsma Joost A, Bezemer Pieter D, Ter Wee Piet M, Amerongen Arie V Nieuw
Department of Dental Basic Sciences, Oral Biochemistry Section, Academic Centre for Dentistry, Amsterdam, The Netherlands.
Kidney Int. 2004 Oct;66(4):1662-8. doi: 10.1111/j.1523-1755.2004.00933.x.
Patients receiving hemodialysis (HD) have to maintain a fluid-restricted diet. Severe thirst can induce noncompliance to this diet, resulting in an increase of interdialytic weight gain (IWG = weight predialysis - postdialysis) associated with poor patient outcomes. Because oral dryness may contribute to experienced thirst, we investigated the possible relation between thirst, salivary flow rate, xerostomia, and IWG.
Unstimulated (UWS) and stimulated (CH-SWS) whole saliva were collected from 94 HD patients (64 men, 54.8 +/- 15.5 years; 30 women, 59.5 +/- 18.7 years). Secretion rates of saliva were determined gravimetrically. Xerostomia was assessed with a validated Xerostomia Inventory (XI), and thirst with a newly developed Dialysis Thirst Inventory (DTI).
Before dialysis, 36.2% of the patients had hyposalivation (UWS < or =0.15 mL/min). The XI scores had a positive relation with IWG (r=.250, P < 0.001). Gender and age differences were observed for thirst, salivary flow rates, and xerostomia. The prevalence and severity of thirst and xerostomia were greater in younger subjects. Patients with urine output did not differ from those without urine output with respect to thirst, xerostomia, and IWG. Correlations were found between thirst (DTI) and both IWG and xerostomia (XI) (r=.329, P < 0.001, respectively; r=.740, P < 0.001). Other correlations were observed between xerostomia and both the salivary flow rate and total number of medications (r=-.252, P < 0.05, respectively; r=.235, P <.05).
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).
接受血液透析（HD）的患者必须维持限液饮食。严重口渴会导致患者不遵守这种饮食规定，进而导致透析间期体重增加（IWG = 透析前体重 - 透析后体重）增加，这与患者的不良预后相关。由于口腔干燥可能会导致口渴感，我们研究了口渴、唾液流速、口腔干燥症与IWG之间可能存在的关系。
收集了94例HD患者（64例男性，年龄54.8±15.5岁；30例女性，年龄59.5±18.7岁）的非刺激性（UWS）和刺激性（CH - SWS）全唾液。通过重量法测定唾液分泌率。使用经过验证的口腔干燥症量表（XI）评估口腔干燥症，使用新开发的透析口渴量表（DTI）评估口渴程度。
透析前，36.2%的患者存在唾液分泌减少（UWS≤0.15 mL/分钟）。XI评分与IWG呈正相关（r = 0.250，P < 0.001）。在口渴、唾液流速和口腔干燥症方面观察到性别和年龄差异。年轻受试者中口渴和口腔干燥症的患病率及严重程度更高。有尿量的患者在口渴、口腔干燥症和IWG方面与无尿量的患者没有差异。发现口渴（DTI）与IWG和口腔干燥症（XI）均存在相关性（分别为r = 0.329，P < 0.001；r = 0.740，P < 0.001）。还观察到口腔干燥症与唾液流速和药物总数之间存在其他相关性（分别为r = -0.252，P < 0.05；r = 0.235，P < 0.05）。
在HD患者中，口腔干燥症（XI）和口渴（DTI）与更高的IWG相关。我们的数据表明，在HD患者中，口腔干燥症与唾液流速和口渴（DTI）均有关。
