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      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

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      Effect of Acupressure on Thirst in Hemodialysis Patients

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          Abstract

          Background: Thirst and dry mouth are common among hemodialysis (HD) patients. This paper reports a study to evaluate the impact of an acupressure program on HD patients’ thirst and salivary flow rates. Methods: The acupressure program included placebo, followed by true acupressure each applied for 4 weeks. Twenty-eight patients (mean age 57.6, SD = 16.13 years) first received a sticker as placebo acupressure at two acupoints CV23 and TE17 three times a week for 4 weeks, and then received true acupressure in the same area for the next 4 weeks. Salivary flow rate and thirst intensity were measured at baseline, during and after treatment completion for both the placebo and true acupressure program. Results: The true acupressure program was associated with significantly increased salivary flow rate (0.09 ± 0.08 ml/min at baseline to 0.12 ± 0.08 ml/min after treatments completion, p = 0.04). The mean thirst intensity also improved from 4.21 ± 2.66 at baseline to 2.43 ± 2.32 (p = 0.008) after treatment completion in HD patients. There was no statistically significant difference in pre-post program salivary flow rate; however, significant improvement in thirst intensity scores was observed (p = 0.009) in the placebo acupressure program. Conclusion: This study provides preliminary evidence that acupressure may be effective in improving salivary flow rates and thirst intensity.

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          Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis.

          Kamyar Kalantar-Zadeh, Deborah Regidor, Csaba P. Kovesdy … (2009)
          Patients with chronic kidney disease (stage 5) who undergo hemodialysis treatment have similarities to heart failure patients in that both populations retain fluid frequently and have excessively high mortality. Volume overload in heart failure is associated with worse outcomes. We hypothesized that in hemodialysis patients, greater interdialytic fluid gain is associated with poor all-cause and cardiovascular survival. We examined 2-year (July 2001 to June 2003) mortality in 34,107 hemodialysis patients across the United States who had an average weight gain of at least 0.5 kg above their end-dialysis dry weight by the time the subsequent hemodialysis treatment started. The 3-month averaged interdialytic weight gain was divided into 8 categories of 0.5-kg increments (up to > or =4.0 kg). Eighty-six percent of patients gained >1.5 kg between 2 dialysis sessions. In unadjusted analyses, higher weight gain was associated with better nutritional status (higher protein intake, serum albumin, and body mass index) and tended to be linked to greater survival. However, after multivariate adjustment for demographics (case mix) and surrogates of malnutrition-inflammation complex, higher weight-gain increments were associated with increased risk of all-cause and cardiovascular death. The hazard ratios (95% confidence intervals) of cardiovascular death for weight gain or =4.0 kg (compared with 1.5 to 2.0 kg as the reference) were 0.67 (0.58 to 0.76) and 1.25 (1.12 to 1.39), respectively. In hemodialysis patients, greater fluid retention between 2 subsequent hemodialysis treatment sessions is associated with higher risk of all-cause and cardiovascular death. The mechanisms by which fluid retention influences cardiovascular survival in hemodialysis may be similar to those in patients with heart failure and warrant further research.
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            Knowledge of dietary restrictions and the medical consequences of noncompliance by patients on hemodialysis are not predictive of dietary compliance.

            Neil V Watson, Claire Durose, Michelle Holdsworth … (2003)
            To investigate whether knowledge of the diet and medical consequences of noncompliance influences dietary compliance among patients on hemodialysis. An interviewer-administered questionnaire assessed patients' knowledge of foods restricted in their diet (four separate scores for knowledge of foods restricted for: potassium, phosphorus, sodium, and fluid); overall knowledge of restricted foods (one composite knowledge score); and knowledge of medical complications of dietary noncompliance (one composite knowledge score). Patients' mean monthly serum phosphorus and potassium and weight charts provided an estimate of dietary compliance. Seventy-one of the eligible 82 patients on hemodialysis at Nottingham City Hospital, Nottingham, UK, participated in the study (87% response rate). Chi(2) tests determined associations between dietary compliance and knowledge scores. More than one third of patients were noncompliant with at least one dietary restriction. Phosphorus dietary restrictions were the most commonly abused and potassium the least. Patients' knowledge of the medical consequences of noncompliance was poorer than knowledge of renal dietary restrictions (mean scores 29.4%; 74.7%). There was no association between compliance with potassium or sodium/fluid restrictions and knowledge of these dietary restrictions. However, patients with better knowledge about phosphorus were less likely to be compliant (P=.03). Patients with better knowledge about the medical complications of noncompliance were less likely to be compliant for phosphorus (P=.002) and sodium/fluid (P=.008) restrictions. These findings question the value of current dietary education techniques in motivating patients to comply with dietary restrictions. Instead of the more traditional approach of information-giving, effective educational methods that focus on motivating patients to comply with dietary restrictions are needed to improve compliance.
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              Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis

              Hong-Seop Kho, Sung-Woo Lee, Sung-Chang Chung … (1999)
              Article 0 comments Cited 37 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): KBR
                Journal ID (nlm-ta): Kidney Blood Press Res
                Journal ID (doi): 10.1159/issn.1420-4096
                Title: Kidney and Blood Pressure Research
                Publisher: S. Karger AG
                ISSN (Print): 1420-4096
                ISSN (Electronic): 1423-0143
                Publication date Subscription-year: 2010
                Publication date (Print): August 2010
                Publication date (Electronic): 02 July 2010
                Volume: 33
                Issue: 4
                Pages: 260-265
                Affiliations
                aSchool of Nursing, bCollege of Nursing, Kaohsiung Medical University, Kaohsiung, cDepartment of Nursing, Tajen University, Pingtung, Taiwan, ROC; dSchool of Nursing and Midwifery, Queensland University of Technology, Brisbane, Qld., Australia
                Author notes
                *Chi-Chun Chin, School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Rd, San Ming District, 807 Kaohsiung, Taiwan (ROC ), Tel. +886 7 312 1101, ext. 2605, Fax +886 7 321 8364, E-Mail chichun@kmu.edu.rw
                Article
                Publisher ID: 317933 Other ID: Kidney Blood Press Res 2010;33:260–265
                DOI: 10.1159/000317933
                PubMed ID: 20606475
                SO-VID: 04cdb4cc-24dd-43c8-8ab9-11b6c89c3303
                Copyright © © 2010 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 11 January 2010
                Date accepted : 23 April 2010
                Page count
                Tables: 2, References: 29, Pages: 6
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Cardiovascular Medicine,Nephrology
                Keywords: Acupressure,Hemodialysis,Thirst,Salivary flow rate
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology
                Keywords: Acupressure, Hemodialysis, Thirst, Salivary flow rate

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