Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey.
Department of Nephrology, Sakarya University, Sakarya, Turkey.
Clin Exp Nephrol. 2023 Oct;27(10):819-827. doi: 10.1007/s10157-023-02373-7. Epub 2023 Jun 23.
With increased fluid intake and tolvaptan treatment, the growth rate of cysts can be theoretically decelerated in autosomal polycystic kidney disease. In this prospective study, it was planned to evaluate thirst sensation in these patients and the parameters affecting its intensity.
Forty-one ADPKD patients on tolvaptan and 40 ADPKD patients not on tolvaptan as the control group were evaluated for thirst distress sensation and intensity. The feeling of thirst and the discomfort caused by excessive fluid intake was assessed with Thirst Distress Scale-HF 12 questions (60/12). Thirst intensity was evaluated with a 100 mm visual scale.
Of the whole group, 35.8% (29) were males, and 64.2% (52) were females. The mean age of the tolvaptan group was 39.17 ± 9.35 years and for the control group, it was 41.95 ± 12.29 years. There was a negative correlation between the thirst distress score of the patients and an increase in creatinine level after a year of tolvaptan treatment (r = - 0.335, p = 0.035). The patients not taking thiazide had higher thirst intensity scores (p = 0.004). There was no impact of tolvaptan dosage, total kidney volume, serum sodium, urinary osmolarity or eGFR on thirst distress and thirst intensity scores.
DISCUSSION/CONCLUSION: Only thiazide co-treatment had a positive impact on thirst distress and intensity when given tolvaptan. Thirst Distress Scale for ADPKD patients can be used to classify patients before and during tolvaptan treatment.
随着液体摄入的增加和托伐普坦的治疗,常染色体显性多囊肾病(autosomal polycystic kidney disease,ADPKD)患者的囊肿生长速度理论上可以减缓。在这项前瞻性研究中,计划评估这些患者的口渴感及其影响强度的参数。
评估 41 例接受托伐普坦治疗的 ADPKD 患者(托伐普坦组)和 40 例未接受托伐普坦治疗的 ADPKD 患者(对照组)的口渴痛苦感和强度。通过 12 个问题的口渴痛苦量表-HF(Thirst Distress Scale-HF 60/12)评估口渴感和过度液体摄入引起的不适。通过 100mm 视觉量表评估口渴强度。
全组中,男性占 35.8%(29 例),女性占 64.2%(52 例)。托伐普坦组的平均年龄为 39.17±9.35 岁,对照组为 41.95±12.29 岁。托伐普坦治疗 1 年后,患者口渴痛苦评分与肌酐水平升高呈负相关(r=-0.335,p=0.035)。未服用噻嗪类利尿剂的患者口渴强度评分较高(p=0.004)。托伐普坦剂量、总肾体积、血清钠、尿渗透压或 eGFR 对口渴痛苦和口渴强度评分均无影响。
讨论/结论:仅噻嗪类药物联合治疗对托伐普坦治疗患者的口渴痛苦和强度有积极影响。ADPKD 患者口渴量表可用于托伐普坦治疗前后的患者分类。