Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon; Department of Nephrology, Saint-Georges Hospital, Ajaltoun, Lebanon.
Department of Nephrology, Saint-Georges Hospital, Ajaltoun, Lebanon.
J Ren Nutr. 2021 Nov;31(6):648-660. doi: 10.1053/j.jrn.2021.01.025. Epub 2021 Mar 12.
Historically, headache was reported in up to 76% of hemodialysis patients. Some authors suggested that headache resulted from caffeine withdrawal. This study aims to compare the incidence of headache and hypotension between patients drinking regular or decaffeinated coffee during dialysis.
One-hundred fifty-six patients were enrolled in this randomized, double-blind, placebo-controlled, multicenter study. Patients with atrial fibrillation were excluded. Group A was given 80 mL of regular coffee and group B 80 mL of decaffeinated coffee (placebo) in the middle of the session for 12 consecutive sessions. Ultrafiltration rate was fixed to a maximum of 13 mL/kg/hour. The primary outcome was the incidence of headache during dialysis.
A total of 139 patients completed the trial (6.4% vs. 15.4% of withdrawal in Groups A and B, respectively). The number of sessions with headache was not significantly different between Group A and B (33.3% vs. 37.1% respectively, P = .522), nor the number of sessions with hypotension (27% vs. 26% respectively, P = .539). In a subgroup analysis, headache tended to be more frequent in Group B (P = .06) in 2 categories of patients: those with the highest potassium dialysate (K = 2) and the non-hypertensive patients.
Headache occurred in 35% of patients during their chronic hemodialysis sessions. Caffeine intake did not prevent headache occurrence in these patients.
在接受血液透析的患者中，高达 76%的患者曾报告有头痛。一些作者认为头痛是由咖啡因戒断引起的。本研究旨在比较在透析过程中饮用常规或脱咖啡因咖啡的患者头痛和低血压的发生率。
这项随机、双盲、安慰剂对照、多中心研究纳入了 156 名患者。排除心房颤动患者。A 组在透析过程中给予 80 毫升常规咖啡，B 组给予 80 毫升脱咖啡因咖啡（安慰剂），共 12 次。超滤率固定在最大 13 毫升/公斤/小时。主要结局是透析过程中头痛的发生率。
共有 139 名患者完成了试验（A 组和 B 组分别有 6.4%和 15.4%的患者出现戒断）。A 组和 B 组头痛的发生次数无显著差异（分别为 33.3%和 37.1%，P=0.522），低血压的发生次数也无显著差异（分别为 27%和 26%，P=0.539）。在亚组分析中，在 2 类患者中，B 组（P=0.06）头痛更频繁：一类是使用最高钾透析液（K=2）的患者，另一类是非高血压患者。
在接受慢性血液透析的患者中，35%的患者在透析过程中出现头痛。在这些患者中，咖啡因摄入并不能预防头痛的发生。
