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Low sodium haemodialysis reduces interdialytic fluid consumption but paradoxically increases post-dialysis thirst

Oliver, A., Wright, Mark, Matson, Andrew, Woodrow, Graham, King, Neil A., & Dye, Louise (2004) Low sodium haemodialysis reduces interdialytic fluid consumption but paradoxically increases post-dialysis thirst. Nephrology Dialysis Transplantation, 19(11), pp. 2883-2885.

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Abstract

Background

Interdialytic weight gain (IDWG) can be reduced by lowering the dialysate sodium concentration ([Na]) in haemodialysis patients. It has been assumed that this is because thirst is reduced, although this has been difficult to prove. We compared thirst patterns in stable haemodialysis patients with high and low IDWG using a novel technique and compared the effect of low sodium dialysis (LSD) with normal sodium dialysis (NSD).

Methods

Eight patients with initial high IDWG and seven with low IDWG completed hourly visual analogue ratings of thirst using a modified palmtop computer during the dialysis day and the interdialytic day. The dialysate [Na] was progressively reduced by up to 5 mmol/l over five treatments. Dialysis continued at the lowest attained [Na] for 2 weeks and the measurements were repeated. The dialysate [Na] then returned to baseline and the process was repeated.

Results

Baseline interdialytic day mean thirst was higher than the dialysis day mean for the high IDWG group (49.9±14.0 vs 36.2±16.6) and higher than the low weight gain group (49.9±14.0 vs 34.1±14.6). This trend persisted on LSD, but there was a pronounced increase in post-dialysis thirst scores for both groups (high IDWG: 46±13 vs 30±21; low IDWG: 48±24 vs 33±18). The high IDWG group demonstrated lower IDWG during LSD than NSD (2.23±0.98 vs 2.86±0.38 kg; P<0.05).

Conclusions

Our results indicate that patients with high IDWG experience more intense feelings of thirst on the interdialytic day. LSD reduces their IDWG, but paradoxically increases thirst in the immediate post-dialysis period.

Impact and interest:

5 citations in Scopus
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5 citations in Web of Science®

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ID Code: 34255
Item Type: Journal Article
Additional Information: Articles free to read on journal website
Keywords: thirst, weight
DOI: 10.1093/ndt/gfh427
ISSN: 1460-2385
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > HUMAN MOVEMENT AND SPORTS SCIENCE (110600)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 2004 ERA-EDTA
Deposited On: 27 Aug 2010 04:24
Last Modified: 29 Jan 2015 01:19

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