Chhaya Kishti T, Mankad Saptak, Shah Maulin K, Patel Mamta, Desai Devangi, Desai Soaham D
Department of Medicine, Central Research Services, Shree Krishna Hospital and Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India.
Department of Biostatistics, Central Research Services, Shree Krishna Hospital and Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India.
Ann Indian Acad Neurol. 2022 Jan-Feb;25(1):82-87. doi: 10.4103/aian.aian_404_21. Epub 2021 Sep 14.
Headache is a frequently encountered symptom among patients undergoing hemodialysis.
The aim of this study was to elucidate the prevalence of hemodialysis associated headache (HDH), its possible etiology, its effect on the patients and steps taken in the management of the condition in Indian patients with end-stage renal disease (ESRD).
A cross-sectional study was carried out amongst 128 consenting patients with ESRD on regular hemodialysis at a tertiary care medical teaching hospital over a period of 3 months to assess for prevalence of HDH and factors related to it. The pre hemodialysis serum electrolytes level, pre and post hemodialysis systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Visual analogue scale (VAS) and patient health questionnaire-9 (PHQ9) was administered to the patients. Test and Chi-square test were applied to find the association between HDH and various postulated factors and a regression analysis was performed.
Among 128 patients, 48 (37.5%) (men 18 [37.5%], women 30 [62.5%]) were found to have HDH. The mean headache severity scores on (VAS) was 4.5 ± 1.74. Patients having HDH had their mean PHQ9 scores 7.56 ± 4.51. Most patients had headaches in the first hour of dialysis and were located in the frontal and temporal part of the head. No statistically significant difference was found in the electrolyte levels between patients having HDH and without HDH. The headache was moderate in most but needed a paracetamol tablet to relieve the headache.
Nearly one-third of patients undergoing dialysis have HDH, and it is associated with mild to moderate depression. The factors leading to HDH and its management need to be evaluated further to improve the quality of life of patients with ESRD on dialysis.
头痛是血液透析患者中常见的症状。
本研究旨在阐明印度终末期肾病（ESRD）患者中血液透析相关头痛（HDH）的患病率、可能病因、对患者的影响以及针对该病症所采取的管理措施。
在一家三级医疗教学医院，对128名同意参与的定期接受血液透析的ESRD患者进行了为期3个月的横断面研究，以评估HDH的患病率及其相关因素。记录透析前血清电解质水平、透析前后的收缩压（SBP）和舒张压（DBP）。对患者进行视觉模拟量表（VAS）和患者健康问卷9（PHQ9）评估。应用检验和卡方检验来寻找HDH与各种假定因素之间的关联，并进行回归分析。
在128名患者中，48名（37.5%）（男性18名[37.5%]，女性30名[62.5%]）被发现患有HDH。（VAS）上的平均头痛严重程度评分为4.5±1.74。患有HDH的患者平均PHQ9评分为7.56±4.51。大多数患者在透析的第一个小时出现头痛，且头痛部位位于头部的额部和颞部。患有HDH和未患有HDH的患者之间电解质水平无统计学显著差异。大多数患者的头痛为中度，但需要服用扑热息痛片来缓解头痛。
近三分之一的透析患者患有HDH，且与轻度至中度抑郁相关。导致HDH的因素及其管理需要进一步评估以提高透析ESRD患者的生活质量。
