Xerostomia, thirst, sodium gradient and inter-dialytic weight gain in hemodialysis diabetic vs. non-diabetic patients

Bruzda-Zwiech, Agnieszka; Szczepańska, Joanna; Zwiech, Rafał

doi:10.4317/medoral.22294

Cited by 14 publications

(17 citation statements)

References 31 publications

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“…Bruzda‐Zwiech et al showed that the predialysis sodium level was associated with hyposalivation, and XI was associated with IDWG (23). In another study, the same authors determined that hyposalivation, DTI, and XI were significantly higher in diabetic patients compared to nondiabetic HD patients, and increased IDWG was associated with the predialysis sodium level (41). Unlike other studies, we used predialysis session POsm, and observed that POsm was negatively correlated with IDWG.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of demographic and clinical risk factors for high interdialytic weight gain

Yılmaz

2021

Ther Apher Dial

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Xerostomia and hyposalivation are highly prevalent in hemodialysis (HD) patients and this is effective in increased fluid intake. The aim of this study is to determine the demographic and clinical risk factors associated with high interdialytic weight gain (IDWG) in nondiabetic HD patients. In total, 52 eligible HD patients were recruited in this cross‐sectional study. Patients were divided into two groups according to % IDWG: Group 1: High IDWG (≥3%) and Group 2: normal IDWG (<3%). Plasma osmolarity (POsm), unstimulated salivary flow rate (USFR), xerostomia inventory (XI), and dialysis thirst inventory (DTI) were evaluated. The mean age of the patients was 53.7 ± 15.7 years. The prevalence of xerostomia was 53.8%, and hyposalivation was in 40.3% in the patients. High IDWG was positively correlated with XI and DTI while it was negatively correlated with POsm and USFR. The area under the receiver‐operating characteristics curve for POsm for high IDWG was 0.661, with sensitivity of 63.8% and specificity of 72.7% for a cut‐off point of 297.4 mOsm/L. Logistic regression analysis showed that advanced age odds ratio (OR: 1.215, p = 0.019), pill burden (OR: 1.162, p = 0.031), C‐reactive protein (CRP; OR: 1.308, p = 0.042), and low POsm (OR: 0.768, p = 0.046) were independently related to high IDWG. The prevalence of xerostomia and thirst was higher in HD patients with high IDWG compared to the normal IDWG group. Age, CRP, low POsm, and pill burden were independently associated with high IDWG.

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Section: Discussionmentioning

confidence: 99%

Evaluation of demographic and clinical risk factors for high interdialytic weight gain

Yılmaz

2021

Ther Apher Dial

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“…The salivary flow is significantly decreased in patients receiving hemodialysis typically by 20‐55% (Figure ). In some patients, severe hyposalivation (saliva secretion <0.1 mL/min) or even absent salivation has been observed . Hyposalivation is often more severe in the presence of diabetes .…”

Section: Pathogenesismentioning

confidence: 99%

“…Two studies have clearly demonstrated that xerostomia is significantly associated with greater IDWG. The adverse outcomes of high IDWG have been well documented making xerostomia, at least indirectly, a significant mortality risk.…”

Section: Consequencesmentioning

confidence: 99%

Xerostomia in patients on chronic hemodialysis: An update

Bossola

2019

Seminars in Dialysis

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Xerostomia, or dryness of oral cavity, is relatively common in patients on chronic hemodialysis and significantly impairs their quality of life. Xerostomia is often the consequence of reduced salivary flow resulting from atrophy and fibrosis of the salivary glands, an event that is of uncertain origin. Many medications commonly used in dialysis patients may also cause or exacerbate xerostomia. Its consequences may be serious and disturbing and include difficulties in chewing, swallowing, tasting, and speaking; increased risk of oral disease, including lesions of the mucosa, gingiva and tongue; bacterial and fungal infections, such as candidiasis, dental caries, and periodontal disease; interdialytic weight gain resulting from increased fluid intake; and a reduction in the quality of life. Therapeutically, stimulation of the salivary glands to increase the production of saliva mechanically by chewing-gum, mouthwash, acupressure, or transcutaneous electrical stimulation has had modest success. However, the long-term effectiveness of such treatments still needs to be investigated and defined. Xerostomia remains a frustrating and disturbing symptom for patients on hemodialysis. Further efforts should be made to find the causes and the mechanisms of the reduced salivary flow observed in patients on chronic hemodialysis.

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“…There is some evidence that there is a positive correlation between xerostomia (hyposalivation) and IDWG [ 6 , 7 , 8 ]. A patient with more serious xerostomia experiences an increase in IDWG because of the increased fluid intake [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Electrical Stimulation of Acupoints on Xerostomia for Patients Who Undergo Hemodialysis

Yang

Lee

et al. 2022

Healthcare

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Xerostomia plays a major role in higher interdialytic weight gain (IDWG), which causes cardiovascular complications in patients who undergo hemodialysis. However, few studies have determined a method to manage xerostomia. This study determines the effect of transcutaneous electrical acupoint stimulation (TEAS) on hemodialysis patients with xerostomia and the percentage of IDWG. The study was a single-blind and quasi-experimental study. There are 75 participants: 37 in the TEAS group and 38 in the contrast group. The TEAS group used 250 µs and 50 Hz and the contrast group used 50 µs and 2 Hz three times a week for 3 weeks to stimulate ST 6 and TE17 acupoints. The salivary flow rates, dry mouth, and %IDWG were determined before, during and one week after the program. Compared with the contrast group, the TEAS group showed a significantly improved salivary flow rate (mL/min) (F (2, 123) = 15.28, p < 0.0001), and patients recovered their normal salivary flow rate. However, the results show that both groups showed significant improvement in dry mouth after treatment. The TEAS group demonstrated no effect in terms of %IDWG, as expected. The results show that a TEAS program is an effective means of symptom management for xerostomia patients who undergo hemodialysis. A TEAS program can be used to manage symptoms for xerostomia patients who undergo hemodialysis.

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Xerostomia, thirst, sodium gradient and inter-dialytic weight gain in hemodialysis diabetic vs. non-diabetic patients

Cited by 14 publications

References 31 publications

Evaluation of demographic and clinical risk factors for high interdialytic weight gain

Evaluation of demographic and clinical risk factors for high interdialytic weight gain

Xerostomia in patients on chronic hemodialysis: An update

Effects of Electrical Stimulation of Acupoints on Xerostomia for Patients Who Undergo Hemodialysis

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