Management of Thirst in Hemodialysis Patients in Primary Services

Abstract

The incidence and prevalence of chronic kidney disease (CKD) has increased worldwide and in Indonesia. There were about 53,940 people with stage 5 CKD based on data from the Indonesian Renal Registry (IRR) in 2018. Incidence crude rate is 251 per million population and prevalence crude rate is 499 per million population for the entire population1. The prevalence of CKD has almost doubled in 5 years, from 2‰ in 2013 to 3.8‰ in 2018. Hemodialysis (HD) is a renal replacement therapy modality that is in great demand by the public compared to the other two modalities, namely peritoneal dialysis and kidney grafts. In 2018, there was a consistent increase in the number of new patients and active HD patients. Active patients is the total number of patients (either new or old patients) who are still undergoing routine HD. The number of new patients has doubled compared to 2017. This also resulted in a sharp increase in the number of active patients compared to the previous year.

The relationship between fatigue, pruritus, and thirst distress with quality of life among patients receiving hemodialysis: a mediator model to test concept of treatment adherence

“…Our findings also demonstrated a significant inverse relationship between TD and QOL. A study on patients receiving hemodialysis reported that fluid restriction caused these patients problems such as thirst, guilt, distress, and anxiety, while their constant exposure to thirst caused them fatigue and reduced their QOL 26 . Dryness of the mouth due to fluid restriction has a direct relationship with thirst and increases the risk of weight gain and orodental problems such as bacterial and fungal infections, candidiasis, dental caries, and periodontal diseases 94 .…”

“…Hence, increased desire for salt intake which is associated with TD. TD can also lead to dryness in the mouth, reduced energy, and fatigue 25 , 26 . These complications may interact with each other, leading to a harmful cycle of negative physical and mental health outcomes.…”