UCL Department of Renal Medicine, Royal Free Hospital, University College London, London, UK.
Artif Organs. 2024 Jan;48(1):91-97. doi: 10.1111/aor.14657. Epub 2023 Oct 30.
Some previous studies have reported an effect of increasing subjective thirst and interdialytic weight gains (IDWG), and that this may be influenced by nonadherence to dietary sodium restrictions, whereas others reported no such association. As such we wished to review the effect of self-reported thirst on IDWGs and dietary sodium intake.
Dialysis patients were asked to complete visual analogues thirst, distress thermometer (DT) scores and complete a sodium food frequency questionnaire (SFFQ). IDWG and pre and post dialysis volumes were measured with multifrequency bioelectrical impedance.
One hundred and eleven patients completed the questionnaires and had bioimpedance measurements: 63% male, mean age 63.8 ± 16.1 years, 33% diabetic with a median thirst score 3 (0-5) and SFFQ 52.0 ± 18, and IDWG 2.1 ± 1.3%. Thirst was associated with DT (r = 0.28, p = 0.004) and negatively with age (r = -0.31, p < 0.001), but not SFFQ, IDWG, extracellular water, or dialysate sodium, or dialysate to plasma gradient. Patients with higher thirst scores were younger (58.0 ± 15.2 vs. 69.4 ± 15.0 years, p < 0.001) with higher DT scores (5 [2-7] vs. 2 [0-5], p < 0.001). On multivariate logistic analysis, only age was associated with self-reported thirst (odds ratio 0.95, 95% confidence limits 0.92-0.98, p < 0.001).
We found that subjective thirst was greater for younger patients and those who reported higher levels of distress, but no association with IDWGs, dietary sodium intake, or dialysate sodium. However, most of our patients followed the dietary advice, as evidenced by the low SFFQ scores and % IDWGs. Whether thirst increases distress or distress increases subjective thirst remains to be determined.
一些先前的研究报告称，增加主观口渴和透析间体重增加（IDWG）会产生影响，而这可能与不遵守饮食钠限制有关，而其他研究则没有报告这种关联。因此，我们希望回顾一下自我报告的口渴对 IDWG 和饮食钠摄入的影响。
我们让透析患者完成视觉模拟口渴评分、痛苦温度计（DT）评分，并完成一份钠食物频率问卷（SFFQ）。IDWG 和透析前后的体积用多频生物电阻抗测量。
111 名患者完成了问卷调查和生物电阻抗测量：63%为男性，平均年龄 63.8±16.1 岁，33%为糖尿病患者，口渴评分中位数为 3（0-5），SFFQ 中位数为 52.0±18，IDWG 中位数为 2.1±1.3%。口渴与 DT 相关（r=0.28，p=0.004），与年龄呈负相关（r=-0.31，p<0.001），但与 SFFQ、IDWG、细胞外液或透析液钠、透析液到血浆梯度无关。口渴评分较高的患者年龄较小（58.0±15.2 岁 vs. 69.4±15.0 岁，p<0.001），DT 评分较高（5[2-7]分 vs. 2[0-5]分，p<0.001）。多元逻辑回归分析表明，只有年龄与自我报告的口渴有关（优势比 0.95，95%置信区间 0.92-0.98，p<0.001）。
我们发现，较年轻的患者和报告痛苦程度较高的患者主观口渴程度更高，但与 IDWG、饮食钠摄入量或透析液钠无关。然而，我们的大多数患者都遵循了饮食建议，这从较低的 SFFQ 评分和 IDWG%可以看出。口渴是否会增加痛苦，或者痛苦是否会增加主观口渴，还有待确定。
