Servizio Emodialisi, Dipartimento Di Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Int Urol Nephrol. 2020 Apr;52(4):697-711. doi: 10.1007/s11255-020-02401-5. Epub 2020 Feb 25.
Thirst has been defined as "the sensation that leads animal's and human's actions toward the goal of finding and drinking water" or as "any drive that can motivate water intake, regardless of cause". Thirst, together with xerostomia, is the main cause of poor adherence to fluid restriction and of excessive intake of fluids in patients on chronic hemodialysis, and consequently of high interdialytic weight gain. Interdialytic weight gain (IDWG) should be lower than 4.0-4.5% of dry weight. Unfortunately, many patients have an IDWG greater than this value and some have IDWG of 10-20%. High IDWG is associated with a higher risk of all-cause and cardiovascular death and increased morbidity, such as ventricular hypertrophy and major adverse cardiac and cerebrovascular events. In addition, high IDWG leads to supplementary weekly dialysis sessions with consequent deterioration of quality of life and increased costs. Thus, the knowledge of thirst in patients on chronic hemodialysis is essential to prompt its adequate management to limit IDWG in the routine clinical practice. The present review aims to describe the physiology of thirst in patients on chronic hemodialysis, as well as the prevalence, its measures, the associated variables, the consequences, and the strategies for its reduction.
口渴被定义为“动物和人类为寻找和饮水而采取行动的感觉”，或者是“能够促使饮水的任何驱动力，无论原因如何”。口渴和口干一起是慢性血液透析患者液体限制依从性差和液体摄入过多的主要原因，也是透析间体重增加（IDWG）过高的主要原因。IDWG 应低于干体重的 4.0-4.5%。不幸的是，许多患者的 IDWG 大于此值，有些患者的 IDWG 为 10-20%。高 IDWG 与全因和心血管死亡风险增加以及发病率增加相关，如心室肥厚和主要不良心脏和脑血管事件。此外，高 IDWG 导致每周需要补充透析治疗，从而导致生活质量恶化和成本增加。因此，了解慢性血液透析患者的口渴情况对于在常规临床实践中及时管理口渴以限制 IDWG 至关重要。本综述旨在描述慢性血液透析患者口渴的生理学，以及口渴的流行程度、测量方法、相关变量、后果以及减少口渴的策略。
