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Low sodium haemodialysis reduces interdialytic fluid consumption but paradoxically increases post-dialysis thirst.
Nephrol Dial Transplant. 2004 Nov; 19(11):2883-5.ND

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.

Authors+Show Affiliations

Leeds University School of Medicine, Leeds, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15340091

Citation

Oliver, Alister, et al. "Low Sodium Haemodialysis Reduces Interdialytic Fluid Consumption but Paradoxically Increases Post-dialysis Thirst." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 19, no. 11, 2004, pp. 2883-5.
Oliver A, Wright M, Matson A, et al. Low sodium haemodialysis reduces interdialytic fluid consumption but paradoxically increases post-dialysis thirst. Nephrol Dial Transplant. 2004;19(11):2883-5.
Oliver, A., Wright, M., Matson, A., Woodrow, G., King, N., & Dye, L. (2004). Low sodium haemodialysis reduces interdialytic fluid consumption but paradoxically increases post-dialysis thirst. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 19(11), 2883-5.
Oliver A, et al. Low Sodium Haemodialysis Reduces Interdialytic Fluid Consumption but Paradoxically Increases Post-dialysis Thirst. Nephrol Dial Transplant. 2004;19(11):2883-5. PubMed PMID: 15340091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low sodium haemodialysis reduces interdialytic fluid consumption but paradoxically increases post-dialysis thirst. AU - Oliver,Alister, AU - Wright,Mark, AU - Matson,Andrew, AU - Woodrow,Graham, AU - King,Neil, AU - Dye,Louise, Y1 - 2004/08/31/ PY - 2004/9/2/pubmed PY - 2005/2/18/medline PY - 2004/9/2/entrez SP - 2883 EP - 5 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 19 IS - 11 N2 - 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. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/15340091/Low_sodium_haemodialysis_reduces_interdialytic_fluid_consumption_but_paradoxically_increases_post_dialysis_thirst_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh427 DB - PRIME DP - Unbound Medicine ER -