NDLI: Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis

Content Provider	Springer Nature : BioMed Central
Author	Yoowannakul, Suree Vongsanim, Surachet Tangvoraphonkchai, Kamonwan Mohamed, Ahmed Davenport, Andrew
Abstract	Background Quality of life for haemodialysis (HD) patients may be affected by symptoms during dialysis treatments, and patient groups have highlighted the need to improve post-dialysis fatigue and dialysis-related symptoms. As changes in extracellular water (ECW) may lead to cramps and other symptoms, we wished to determine whether there was an association between ECW and intra-dialytic symptoms. Methods We reviewed the hospital records of HD patients who completed a self-reported intra-dialytic symptom questionnaire, using a visual analogue scale, who had contemporaneous pre- and postdialysis bioimpedance ECW measurements adjusted to height (aECW). Results We studied dialysis sessions of 506 patients, 314 (62.1%) male, 226 (44.7%) diabetic, mean age 64.6 ± 15.7 years, weight 69.9 ± 17.4 kg, and duration of dialysis treatment 26 (9.6–60.1) months. We divided patients into three groups according to pre-dialysis aECW, and total dialysis symptom scores were greater for those in the lower tertile (25 (10–41) vs middle 18 (8.5–34) vs upper 20 (7–31), p < 0.05). Only feeling cold, dizziness, and low blood pressure were statistically different between the three pre-dialysis aECW groups, and there was no difference in post-dialysis recovery times. We analysed the effect of the fall in aECW pre-to post-dialysis. Patients in the group with the greatest fall in aECW did not report more intra-dialytic symptoms or longer recovery times. Conclusion We found that patients starting dialysis with lower relative ECW were more likely to report intra-dialytic symptoms than those with greater amounts of fluid to remove, and most commonly reported symptoms were associated with intra-vascular volume depletion.
Related Links	https://rrtjournal.biomedcentral.com/counter/pdf/10.1186/s41100-021-00321-3.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	20591381
DOI	10.1186/s41100-021-00321-3
Journal	Renal Replacement Therapy
Issue Number	1
Volume Number	7
Language	English
Publisher	BioMed Central
Publisher Date	2021-01-30
Access Restriction	Open
Subject Keyword	Nephrology Haemodialysis Distress thermometer Extracellular water Cramps Headaches
Content Type	Text
Resource Type	Article
Subject	Transplantation Nephrology Urology

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